
ikd^co^ £ y^W. 



A TREATISE 



ARTIFICIAL LIMBS 



RUBBER HANDS AND FEET 



Containing a Brief History of Prothesis, Descriptions of Rubber Feet and Arti* 
ficial Legs, Rubber Hands and Artificial Arms, Apparatus for Deformities, 
etc. An Argument on the Advisability of Applying Artificial Legs 
to Growing Children and to the Aged. The Longevity of the 
Maimed. Amputations Prothetically Considered, and the 
Relation of Prothesis to Surgery, etc., etc., etc., together 
with Awards from Industrial Expositions, Testi- 
monials from Physicians and Patrons. 



EIGHT HUNDRED ILLUSTRATIONS 



A. A. MAEKS 

701 Broadway, New York City, U. S. A. 

1899 
Telephone, 778 Spring. Cable Address, " Artificial," New York, ABC Codh 



Copyright, 1899, by A. A. Marks 



- -- ... TW O. COPIES. RECEIVED, 

:uy of CuTigre»% 
Uffle* of the 

^«^l«fer of Copyrights 

PEEFACE. 
54221 

This book is a treatise on prothesis, in contradistinction to a pamphlet or 
catalogue. It is a dissertation on stumps, deformities, and the manner in 
which dismembered bodies are repaired by prothesis. The book is abundantly- 
illustrated, in order to give clearness to the text. 

An effort has been made to parallel every possible case of amputation and 
deformity of the extremities, or so nearly so as to convey with distinctness the 
methods that are to be adopted for their correction. Any person who is 
maimed in leg, arm, foot, or hand will be able to find a case almost identical 
with his own, and to learn how such case was prothetically treated. It is to 
be hoped that this book will dispel that gloom which naturally comes to one 
on whom misfortune has placed its baneful hand. 

To many persons the life of a cripple is a blighted existence. The loss of a 
leg or an arm is a sore bereavement, but the time has arrived when remedial 
measures are so effective that the loss of a limb is to be regarded as a minor 
misfortune, not as serious as the impairment of health or the loss of any one of 
the senses. What has been done can be done again. The thousands of limbless 
persons who have had their disabilities removed are but evidences that there is 
a bright future and an agreeable compensation for every affliction that may 
happen to the human extremities. 

The cuts are made from photographs taken from life. The collection of 
photographs, the preparation of cuts, and the arrangement of material has 
been a task of no mean dimensions. It has occupied a great amount of time 
and consumed a great amount of labor. 

The illustrations begin with No. 501, and continue ad seriatim. This has 
been done to escape confusion with the illustrations in former editions. 

The book, for the sake of convenience, has been divided into four parts *. 
The first relates to artificial legs ; the second, to artificial arms ; the third, 
to general information, a part of which is of special interest to the surgical 
profession and to those more remotely interested in the subject; and the 
fourth contains indorsements from the medical and surgical professions, tes- 
timonials from the wearers and other sources. 

The article on the advisability of applying artificial limbs to growing chil- 
dren and to the aged must be of interest to those who are concerned in the wel- 
fare of the dismembered youth and those in the decline of life. The article on 
the longevity of the maimed has been carefully prepared from reliable data. 

The attention of the medical and surgical profession is called to the articles 
on "Amputations Prothetically Considered" and "Relation of Surgery to 
Prothesis." Comments on the author's views on the above subjects are 
invited. 

The testimonials are arranged in the following order : Those from physi- 
cians and those from the wearers. The latter are arranged alphabetically, 
according to States. The addresses of the writers are not given in full, in 
order to protect them from the harassments of competitors. 

Any correspondent who desires to communicate or confer with any number 
of the testimonial writers can obtain full addresses by communicating with 
the office. It is the wish of the house to put applicants in correspondence 
with those who are wearing artificial limbs, who have had an extended expe- 
rience, and who reside in the same or adjacent counties. 

A. A. Marks is the name of the firm, the members of which are A. A, 
Marks, George E. Marks, and Wm, L. Marks. 

George E. Marks, A. M. 
December 15, 1899. 



iv 



SfcC-.-/J U' t. 



TABLE OF CONTENTS. 



Preface, 



PART I. 

Abtificial Legs and Feet. 



A bit of history, 

Cork legs, 

Early experiences, 

The rubber foot, 

The spring mattress, . 

Motions of the natural foot and ankle when walking, 

Cost of wearing, ...... 

Weight, odor, and the effects of temperature on rubber feet, 
The weight of an artificial leg, .... 

How long will an artificial leg last, . 

Stockings and shoes, ...... 

Fittings, ....... 

Changes that take place in the stump after a limb has been applied, 
Requirements, ..... 

Rubber feet with ankle joints, 

Descriptions of artificial legs suitable for thigh stumps, 
Artificial legs for hip- joint amputations, . 
Knee-lock, . . . 

Artificial legs for long thigh stumps, 
Prices, . . . • . . 

Artificial legs for knee-joint amputations, . 
Artificial legs for below-knee amputations, 
Knee-joints with removable bushings, 
jstems for lacing, ...... 

I hortened thighs, ..... 

.•regular curved natural knee-joints, 

'ontracted stumps, 

artificial legs without thigh parts, . 

Natural crook legs, ... 

<vrtificial legs for ankle-joint amputations, 

Aluminum sockets, . ... 

Artificial legs for partial feet amputations, 
Artificial toes, ...... 

Artificial legs for double amputations ; 
Appliances, braces, and extensions for shortened limbs, 
Apparatus for resections, deformities, and deficiencies, 
Peg legs, ...... 

Rubber feet attached to old artificial legs, 
Suspenders, ...... 

Suspenders for women, .... 

Suspenders for double amputations, 

Directions for taking measurements and diagrams for artificial legs, 

a Thigh stumps, .... 

5 Knee-joint stumps, 

c Below-knee and knee-bearing stumps, 

d Ankle-joint or partial foot stumps, . 

e Measurements and diagrams required when both legs are amputated, 

/ One leg amputated above or in the knee, the other below the knee, 

g Both legs amputated below the knees, .... 

Importance of applying artificial legs to young and growing children, 

The case of Carrie Kuntz, ...... 

The case of Thomas Kehr, 

Dr. Brady's letter, ....... 

Various cases treated and letters from physicians and others, 
Double synchronous amputation of both legs in an infant— Recovery, 
Artificial limbs applied'to th§ aged, ..... 

Letters on the subject, ....... 



PAGE 
11 

18 
19 
23 
24 
28 
32 
33 
34 
36 
37 
37 
39 
40 
41 
42 
50 
53 
54 



86 
88 
90 
93 
96 
103 
106 
115 
117 
140 
140 
162 
166 
167 
175 
177 
178 
178 
182 
183 
188 
188 
189 
190 
193 
197 
197 
198 
199 
209 
212 
2H 



VI 



TABLE OF CONTENTS. 



PAET II. 



Artificial Arms and Hands. 

Artificial arms, . . • . 

The rubber hand, ..... 

Accessories, ...... 

Palmar and dorsal flexion and extension of hand, 

Mortise and tennon wrist connection, 

Spring thumbs, ..... 

Natural color, . . . . . 

Sockets, ...... 

Aluminum, ...... 

Artificial arms for shoulder-joint amputations, 
Malformed arm treated as a shoulder-joint amputation, 
Artificial arms for above-elbow amputations, 
Artificial arms for below-elbow amputations, 
Arms for wrist-joint amputations, first class, 
Arms for wrist-joint amputations, second class, . 
Artificial arms for double amputations, 

Both amputations above elbow, 

One amputation above elbow and one below, . 

Both amputations below elbow, 
Partial hand amputations, .... 

Deformities, apparatus for resections, etc., 
Apparatuses, . . . . . 

Bubber hands applied to artificial arms of other construction than our own,* 
Peg arms, ...... 

Suspenders for artificial arms, 

Implements, ...... 

Utility, ...... 

Directions for taking measurements for one or a pair of artificial arms, 
List of patents and a word of caution, ..... 

PART in. 

General Inforblation. 

Instructions for taking plaster casts of stumps, . 
The simple method, ..... 

Division method, ..... 

String method, ..... 

Plaster bandage method, .... 

Artificial limbs made and fitted from measurements without the presence of 
the wearers, . . . . . . - 

Where we are located, ..... 

Calls made to residence, ..... 

Lady attendants, ...... 

Branches, ....... 

Prices, legs, ....... 

Prices, arms, ....:.. 

Accessories, ..... . 

Terms of payment, ...... 

Installment payments, ..... 

Guarantee, . . . . . . . 

How soon after amputation should an artificial leg be applied ? 
Dr. Cook's opinion on the subject, .... 

Manufacturer to the United States Government, . 

Our records, ....... 

The longevity of the maimed, .... 

Amputations prothetically considered, 

I. Length of stumps, ..... 

a Advantages of a totally or partially amputated foot, 
6 Advantages of a stump extending below the knee over a stump 
extending to the knee, ..... 

c Advantages of a stump extending to the knee over that of 
shorter stump, .... 

IT. Flaps, 

in. The location of cicatrices, 

IV. Treatment of stumps after they have become healed, 
V. Time to apply an artificial leg, . . • 

The case of an infant as an illustration, 
Paper read before the Pan-American Medical Congress, . 



TABLE OF CONTENTS. 



VII 



Relation of surgery to prothesis, 

a Length of stumps, 

6 Flaps, ..... 

c Ankle-joint and partial foot amputations, 

d Retracted heels and contracted tendo-achillis, 

e Redundant flaps, 

/ Extended and ankylosed stumps, 

g Deflected tibial stumps, 

h Anomalous flaps, 

i Knee disarticulations, 

j Hypertrophy, 

k Atrophy, 

I Bearings, 

m Sinuses, 

n Adhesions, 

o Conical stumps, 
From the stump to the limb, 
Awards 

American Institute, New York, 1859, 1865, 1867, 1869, 

American Institute, New York, 1870, 1871, 1872, 1873, 1874, 

American Institute, New York, 1875, . . 

Centennial Exhibition, .... 

American Institute, 1876, 1877, 1878, . 

International Cotton Exposition, Atlanta, Ga., 

The World's Industrial and Cotton Centennial Exposition, New Orleans, 
La., 

The John Scott Legacy Premium and Medal, 1889 

Augusta, Ga., Exposition, 1891, 

Franklin Institute, The Elliott Cresson's Gold Medal, 1893, 

Columbian Exposition, Chicago, 111. , 1893, 

Cotton States and International Exposition, Atlanta, Ga., 1895, 

American Institute, New York, 1896, 

Tennessee Centennial and International Exposition, Nashville. Tenn., 1897 
Trans-Mississippi and International Exposition, Omaha, Neb., 1898, 

PART IV. 
Testimonials and Commendations. 



page 
323 
325 
325 
328 
329 
334 
335 
336 
337 
338 
341 
342 
344 
345 
346 
346 
348 



370 
371 
371 
372 
372 

373 
373 
377 
377 
382 
383 
383 
3«3 
384 



What the doctors say, 












387 


What the wearers say, Alabama, 












395 


Arizona, 












396 


Arkansas, 












396 


California, „ 












397 


Colorado, 












400 


Connecticut, 












401 


Delaware, 












406 


District of Columbh 


* 










406 


Florida, 












408 


Georgia, 












409 


Idaho, 












413 


Illinois, 












413 


Indiana, 












415 


Indian Territory, . 












418 


Iowa, 












419 


Kansas, 












421 


Kentucky, . 












423 


Louisiana, . 






— , 






425 


Maine, 












425 


Maryland, . 












427 


Massachusetts, 












430 


Michigan, 












436 


Minnesota, . 












439 


Mississippi, . 












440 


Missouri, 












441 


Montana, 












442 


Nebraska, 








<* 




443 


Nevada, 












444 


New Hampshire, 












445 


New Jersey, 












446 


New Mexico, 












452 


New York, . 












452 


North Carolina, 












474 


North Dakota, 












475 


Ohio, 












475 


Oklahoma Territory 


i 










479 



Vlll 



TABLE OF .CONTENTS. 



PAGE 


What the wearers say, Oregon, .... ■£■ . 480 


Pennsylvania, 










482 


Rhode Island, 










491 


South Carolina, 










492 


South Dakota, 










493 


Tennessee," . 










495 


Texas, 










497 


Utah, 










498 


Vermont, 










499 


Virginia, 










500 


Washington, 










501 


West Virginia, 










501 


Wisconsin, . 










502 


Wyoming, . 










506 


Canada, 










506 


Newfoundland, 










509 


Mexico, 










510 


Costa Rica, C. A., . 










511 


San Salvador, C. A., 










511 


Peru, S. A., . 










512 


Chile, S. A., 










512 


Cuba, 










512 


Jamaica, W. I., 










512 


England, 










513 


Ireland, 










513 


Holland, 










513 


Germany, 










514 


Denmark, 










514 


New Zealand, 










514 


Hawaiian Islands, . 










515 


Straits Settlements, 










515 


Japan, 










516 


China, 










517 


South Africa, 


* 








518 


Foreign Money Equivalents, 










518 


Stump socks for artificial limb wearers, 










519 


Webbing "" " " . 










520 


Knife and fork combined for one-armed persons. 










521 


Press-button pocket knives, 










522 


Crutches, . . . 










523 


Crutch ferrules and crutch rubbers, 










525 


Invalid, reclining, and rolling chairs, 










527 



PART I. 
ARTIFICIAL LEGS AND FEET. 



A BIT OF HISTORY. 




EARLY half a century ago two brothers, natives of Con- 
necticut and residents of New York City, embarked upon 
the prosthetic* industry. They were inventors and me- 
chanics, abundantly endowed with that sympathizing 
nature that impels the proffering of aid to those with whom 
the adversities of life had been severe. D. B. Marks was the elder, and 
A. A. Marks the younger. Both had been prosperous in their separate 
vocations, but were nevertheless easily persuaded to engage in an occu- 
pation that seemed to be more congenial to their dispositions. D. B. 
Marks had devised a plan for an artificial leg, and, assisted by his 
brother, set about to develop that plan. A copartnership was formed 
in 1853, and the two brothers entered upon their new enterprise with 
much zeal, but with little familiarity with the prothetical status of 
those times. The artificial leg made by the new firm was put into 
practical use, and the success immediately achieved appears to have 
given them much hope. The United States Government protected the 
invention, and issued letters patent, bearing date March 7, 1854. 

For a few months the labors of the firm met with little recognition. 
The demand for artificial limbs proved to be more limited than 
had been anticipated, and seemed to have been under the control of 
better known protheticians.f This condition brought discouragement; 
it was apparent that much sacrifice would be involved, with more 
gloomy prospects of success than hope had led the novices to antici- 
pate. The senior brother became disconsolate and withdrew, resuming 
his former occupation. A. A. Marks adhered to his purpose. He 
busied himself with devising and perfecting improvements, invent- 
ing and constructing artificial arms, hands, and feet, and thus 
enlarging the scope of his endeavors. Through all adversity and 
bitter rivalry he cherished the hope that his efforts would in time 
make themselves felt, and that by his labor and genius the conditions of 
the maimed and the deformed would become bettered. He was devoted 
to his profession, and never entertained regret for having applied him- 
self to an art that proved to be unremunerative for many years. He 
visited hospitals, interviewed prominent surgeons, made himself ac- 
quainted with the anatomy and physiology of the human extremities, 
he gathered points from every available source, and quietly appropri- 

* Prosthetic — a. of prosthesis, same as protheais. The process of adding to the human body 
some artificial part in place of one that may be wanting, 
t Prothetician— One engaged in prothesis. 

11 



12 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



ated them to his profession. He made a close study of every case that 
came under his care ; not a condition favorable for prosthetic purposes 
escaped his detection, and not a condition, however complex, puzzled his 
fruitful mind. His heart and his energies were devoted to one pur- 
pose and thus, by work and thought, he amply fortified himself for the 
results that have made him distinguished. His zeal soon brought him 
to the front, and many years ago he was the acknowledged authority 
on the subject of prosthesis. 

In a few brief years Mr. Marks had amassed more experience, had 
conceived more ideas, had originated more systems, and had accom- 
plished more for the relief of the maimed than the combined achieve- 
ments of all who had preceded him. 

A glimpse at the status of artificial-limb making, fifty years ago, is 
all that is necessary to show that the brainy and indefatigable New 
Englander had selected a field in which there were opportunities for 
the genius which he possessed. 




No. 501. No. 502. 
Pare Leg, Made in the Year 1561. 



Fifty years ago, artificial-limb making was but the relic of the six- 
teenth and seventeenth centuries. Prosthesis had not yet become a 
modern art. Appliances for the relief of the crippled that might be 
catalogued with artificial legs and arms were simply the reproduction 
of the works and ideas of mechanicians referred to by the celebrated 
Ambrose Pare (1561),Verduin (1696), and other early writers on medi- 
cine and surgery. 

The fact is obvious that, in very early times, all persons who lost their 
limbs by accident, disease, or the misfortunes of war, were not doomed 
to a life of helplessness. The few that survived the operation and 
shock had some methods by which their lives might be rendered worth 
the living. The indigent were obliged to depend on such makeshifts 
as peg legs, the affluent commanded the attention and genius of the 
skilled mechanic, and whether he fared any better than his impecuni- 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 13 

ous neighbor by having appended to his stump a mass of noisy, cum- 
bersome machinery, is a matter for conjecture. 

Prominent among the evidences that artificial legs were made in very 
early times is an exhibit at the Museum of the Royal College of 
Surgeons in London. That exhibit consists of the remains of an old 
artificial leg which was exhumed from a tomb at Capua in 1858. 
The official catalogue describes the leg thus : 




No. 503.— Verduin Leg, Made in the Year 1696. * 

" Roman artificial leg ; the artificial limb accurately represents the 
form of the leg; it is made with pieces of thin bronze, fastened by 
bronze nails to a wooden core. Two iron bars, having holes at their 
free ends, are attached to the upper extremity of the bronze; a quadri- 
lateral piece of iron, found near the position of the foot, is thought to 
have given strength to it. There is no trace of the foot, and the 
wooden core had nearly crumbled away. 

" The skeleton had its waist surrounded by a belt of sheet bronze, 
edged with small rivets, probably used to fasten a leather lining. 

' ' Three painted vases (red figures on a black ground) lay at the feet 
of the skeleton. The vases belong to a rather advanced period in the 
decline of art (about 300 years B. c.)." 

Herodotus tells us of an Elean, the most renowned of the Tellidse, 
whom the Spartans had captured, and as they had suffered many 
atrocities from his hands, he was doomed to death. In this sad con- 
dition the Elean, knowing that his life was in peril and that death 
would follow many tortures, performed a deed beyond belief. He was 
confined in stocks with one foot bound in iron. He got possession of 
a knife, which by some means had been left near to him, and imme- 
diately cut off the broad part of his own foot. As he was guarded by 
sentinels outside of the wall, he dug a hole under the Avail and escaped 
to Tegea, traveling by night and hiding himself during the day. In 
time he was cured of his wounds and procured a wooden foot, and 
immediately became an avowed enemy to the Lacedemonians. 

Pliny tells us of M. Sergius, 167 b. c, who wore an artificial hand 
of his own construction, with which he fought a battle, and released 
Cremona from siege. 



14 A. A. MAEKS, AETIFICIAL LIMBS, NEW TOEK CITY. 

"M. Sergio ut equidem arbitror, nemo quemquam hominum jure 
praetulerit, licet pronepos Catilina gratiam nomini deroget. Secundo 
stipendio dextram manum perdidit,* . . dextram sibi ferream fecit, 
eaque religata prceKatus Cremonam obsidione exemit." 

Pliny further says : "He prostrated Placentia and took twelve of 
the enemy's camps in Gaul; all this appears from the speech which he 
made on his prsetorship, when his colleagues wished to shut him out 
of the sacred rites as a mutilated man." 




No. 504.— Goetz von Berlichlngen Hand, Made in the Yeae 1504. 

The hand made for Goetz von Berlichingen in 1504 was a compli- 
cated structure, heavy and more or less cumbersome, being made of 
iron, but nevertheless served the -purpose for which it was intended, 
that of holding the bridle of a horse, or a shield to protect his body. 
With this hand he fought at the head of the army of Margrave 
Frederick. 

An iron arm (described by Ambrose Pare" in 1564), was made for a 
Huguenot captain of the sixteenth century, who had his left arm shat- 
tered at the siege of Fontenoy by a shot from an arquebuse ; he refused at 
first to have his arm amputated, stating that he would rather die than 
suffer amputation, as without his natural hand he would not be able 
to again engage in battle. His friends persuaded him at last, and the 
Queen of Navarre, who held him in high esteem, is said to have held 
his hand while it was being amputated. An iron arm was made for 
him, which enabled him to hold the bridle of his horse, and he returned 
to battle with more vigor than before. 




No*. 505.— Pare Hand, Made in the Year 1564. 

During Ambrose Parens time much thought was given to the perfec- 
tion of artificial limbs, particularly arms and hands. Iron hands 
were objectionable on account of their weight, and arms of leather 
and paper-and-glue were made in substitution, Le petit Lorrain, a 
* C. Plinii, Hist. Nat., 28, 104-106. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 15 

French locksmith, was in all probability the most distinguished maker 
in those days. He operated under the suggestions of Pare, and pro- 
duced limbs that were very creditable. Latterly, a Carmelite monk, 
Father Sebastian, devoted some attention and study to the subject, and 
produced an artificial arm that was capable of many articulations, 
employing sheet-tin and springs in its construction ; but the apparatus 
of Father Sebastian failed to meet with anticipated success on account 
of the unreliability of stumps, as dependence on the firmness of tissue 
caused the articulations to cease as soon as the stump became 
attenuated. 

A mechanic by the name of Bailliff is accredited with having made 
artificial arms that were improvements on the ideas of Father Sebas- 
tian. Some authorities, however, dispute the originality of Bailliff's 
arms. In 1696 a Dutch surgeon by the name of Verduin invented an 
artificial leg, which was improved by Serre, and met with much favor. 




No. 506. 

Gavin Wilson is said to have improved Father Sebastian's arm by 
employing harder leather, and covering the same with colored sheep- 
skin so as to bear the appearance of human 'skin, and to render the 
deception still more complete, he made the nails of white horn, and 
painted them so as to represent nature. 

In 1818 De Graefe suggested a mechanical procedure which is fol- 
lowed by European manufacturers at the present time. 

Thus, step by step, with occasional lapse of time, we are brought to 
the present age. Cobblers, harness-makers, locksmiths, and other 
mechanics were the protheticians of the past. These were employed 
by affluent cripples in order to escape the obloquy of the peg leg 
(Peter Stuyvesant's style, 1620). It can well be understood that pro- 
ductions from those sources, although ingenious in their mechanical 
arrangements, were poorly adapted to the needs of the dismembered. 
They were heavy, noisy, clumsy, improperly fitted, and agonizing to 
wear; in short, they were makeshifts that would not be tolerated in 
the present age. 

An advertisement in the Old Countryman, New York, in the early 
part of the present century, announced that one by the name of 
Thomas was prepared to receive orders for " Cork Legs," constructed 
on an advanced principle. The advanced principle appears to have 
been a comely and approximately natural shape given to the primitive 
peg leg, so that it could be worn inside of the clothing. 



16 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

Up to the beginning of the present century France, Holland, and 
Germany were the advanced manufacturers of artificial limbs. Begin- 
ning with the present century, England seems to have taken the lead 
from her sister countries. In 1790 and in 1810 English patents on arti- 
ficial limbs were issued to one by the name of Thomas Mann, and in 
1800 James Potts of England applied for a patent on an artificial leg, 
which was granted by the British Government. Mr. Potts' invention 
consisted of a wooden leg, very simple in construction. The leg was 
suggested and used by the Marquess of Anglesea, who lost his leg in the 
battle of Waterloo. That leg has since been known by the sobriquet 
of the "Anglesea leg." William Selpho, an Englishman and protege 
of Potts, left England and came to America in 1839, and introduced the 
Anglesea leg into this country. Selpho may be considered as the first 
manufacturer in America who attained prominence. He made an artifi- 
cial leg for a young man by the name of B. F. Palmer, who, being gifted 
with an inventive turn of mind, sought to improve the Selpho leg, and 
in 1846 obtained from the United States Government the first patent 
issued in this country on artificial limbs. Palmer forthwith estab- 
lished himself as an American manufacturer. In 1849, he improved 
the leg and obtained his second patent. In the following year George 
W. Yerger obtained a third patent issued by the United States Govern- 
ment, and in the same year a patent was issued to W. C. Stone. In 
1852 Palmer obtained the fifth patent, and in the same year the sixth 
patent was granted to J. Eussell and the seventh to J. S. Drake, and on 
March 7, 1854, the eighth patent on artificial limbs was granted to D. B. 
Marks, referred to on the first page of this book. Yerger, Russell, and 
Drake never became known outside of the Patent Office. Selpho, 
Palmer, and Marks were the first to make an impression on the pros- 
thetic industry in America. The works of these inventors have 
placed America far in advance of all nations in this field of labor, a 
position which America holds to-day more strongly than ever before, 
while England has made no practical advance on the Anglesea leg, and 
France adheres to the productions of Charrier and Mathieu, which are 
but slight modifications on the works of Verduin, Serre, le petit 
Lorrain, and Graefe. Germany seems to cherish the historic arm of 
the German knight and the leg of the Dutch Verduin ; but America, 
ever alert, grasped the situation at an early date, and has since made 
remarkable strides in attaining the present stage of perfection. From 
1846 to 1895 the United States issued 214 letters patent on artificial legs 
and their attachments, and 35 letters patent on artificial, arms ; or a 
total of 249. Of this number the firm of A. A. Marks has been accorded 
ten distinct and separate letters patent. 

From the introduction of the " anglesea " leg, 1800, to the beginning 
of the Civil War, 1860, very few artificial Kmbs were manufac- 
tured, and progress in the industry was exceedingly slow; but- the 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 17 

War deprived such a vast number of their natural legs and arms that 
the demand for artificial ones became very large. The United States 
Government adopted measures at an early date to furnish its maimed 
soldiers with artificial limbs, and commissioned and authorized chosen 
manufacturers to supply them at Governments expense. The demand 
was further augmented by the rapid extension of railroad systems 
throughout the country; the increase of manufactories that employed 
ponderous and dangerous machinery ; the invention and introduction 
of agricultural implements, such as mowing machines, reapers, 
threshing machines ; the opening of mines, and the conversion of great 
forests into timber for building purposes. Although these have been 
regarded as "implements of civilization," they have had their dis- 
tressing effect in dismembering the human body. 

Surgery has changed ; the methods of half a century ago are unlike 
those of the present day. Toxic germs, the bane of the surgeon, have 
yielded to antiseptics, and the mortality attending amputations for the 
removal of diseased and mangled parts has become minimized. Many 
lives are now saved by modern surgery which in former times would 
have been lost. All these have served as important causes jn creating 
new fields and enlarging old ones for the prothethist. 



18 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



CORK LEGS. 

The term u cork leg" is a misnomer, a sort of sobriquet for artificial 
legs in general. The material, cork, has never been used to any con- 
siderable extent in the construction of artificial legs. Cork is friable 
and insufficiently resistant to form any part of the supporting struc- 
ture. The term has no significance, other than that the leg is artificial. 
The origin of the term "cork leg " is lost, and nothing in the annals of 
history or literature discloses any reason why the term should apply. 
There are, however, doggerels and opprobrious allusions found in the 
works of satirical authors applied to persons wearing " cork legs," as, 
for instance, the " Song of the Cork Leg," author unknown: 

11 I'll tell you a tale now without any flam : 
In Holland there dwelt Mynheer Yon Clam, 
Who every morning said, ' I am 
The richest merchant in Botterdam ! ' 
i Hi tu, di nu, di nu, di nu, 
Ei tu, di nu, ri tu, di nu, ri na." 

" ' Mr. Doctor,' says he, when he'd done his work, 
' By your sharp knife I los,e one fork ; 
But on two crutches I never will stalk, 
For I'll have a beautiful leg of cork.' 
Ei tu, di nu," etc. 

Thomas Hood, in his Golden Legend, ' ' Miss Kilmansegg and Her 
Precious Leg," speaks of cork and wooden legs, neither of which was 
good enough for the fastidious Countess : 

"But when it came to flitting the stump 
With a proxy limb— then flatly and plump 

She spoke in the spirit olden. 
She couldn't, she shouldn't, she wouldn't have wood, 
Nor a leg of cork if she never stood ! 
And she swore an oath, or something as good, 
The proxy limb should be golden ! " 

It must be admitted that in our times the term " cork leg " is used 
very generally and synonymously with ' ' artificial leg. " 

It is possible that the term " cork leg " had its origin in the fact that 
in olden times peg legs were sometimes made from a strong piece of 
wood, cut to proper length to extend from the supporting surface of 
the member to the ground. This stick was surrounded by cork in 
order to obtain shape and dimensions approximately the same as the 
natural leg. Cork would, in this case, be used on account of its light- 
ness, all the superincumbent weight being supported by the wooden stick. 

Another explanation, bearing a shade of plausibility for the use of 
the term ' ' cork leg, " may be found in the fact that some years ago 
artificial legs were made in Cork, Ireland, and the artificial legs made 
in that city were termed " Cork legs," the same as legs that are made 
in London are called " London legs," or those that are made in New 
York are called "New York legs." 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



19 



EARLY EXPERIENCES. 

When D. B. and A. A. Marks began the manufacture of artificial 
limbs in 1853, they met with many difficulties on account of the un- 
limited range of prosthesis and the very limited resources at their com- 
mand. They had original ideas, but depended much on experiments 
to prove the plausibility of those ideas. The productions of their only 
two competitors were not available, and the advice, conditions, needs, 
and experiences of the few subjects with whom these neophytes had 
intercourse formed the only material for their investigations, the only 
school for their instruction. The thoroughness with which their oper- 
ations was conducted can only be comprehended by contrasting the 
industry of those days with the industry of the present times. 






No. 507. 
Marks' Leg, 1853. 



No. 508. 
Marks' Leg. 1856. 



No. 509. 
Marks' Leg, 1896. 



The artificial leg manufactured by A. A. Marks in 1853 is represented 
in sectional cut No. 507. It will be seen that this leg possessed ma- 
chinery at the knee, ankle, and toe, and movements were obtained by 
intricate mechanism. The leg manufactured by A. A. Marks in 1856 
is represented in cut No. 508. This leg, like the former one, had knee, 
ankle, and toe movements, but the results Avere obtained by more prac- 
tical methods. This leg received the Highest Award at the American 
Institute Exhibition in 1859. Cut No. 509 represents the last marked 
improvement in artificial legs. The leg has knee articulation; the 



20 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

foot is of rubber, by means of which all mechanism, from the calf 
of the leg down, is dispensed with. This leg is more fully described 
in the following pages. The leg of 1856 was a marvel in its day. Its 
knee, ankle, and toe articulations were provided with adjustments that 
took up all lost motion that came from wear, the range of articulation 
was adjustable, being capable of changes to suit the wants of the 
wearer. As an evidence of the esteem with which this leg was regarded 
by. the profession, it is but necessary to refer to the very great compli- 
ment that was paid to Mr. Marks in the year 1860, when the Japanese 
Embassy visited New York. 

Kawasaki, of the Embassy, having expressed a desire to visit an Ameri- 
can manufacturer of artificial limbs, was conducted to the establishment 
of Mr. Marks. The following is taken from a New York daily paper : 

" The Embassy was escorted to the establishment of Mr. Marks, 
manufacturer of artificial limbs. The proprietor showed the doctor 
through his manufactory and explained the mechanism of his appa- 
ratus, with which the Oriental visitor appeared very much gratified, 
stating that nothing of the kind was known in his country. During 
the interview Mr. Marks took occasion to present .the Japanese doctor 
with one of his most beautiful legs ; at the same time expressing the 
wish that his visitor might never have other occasion for, it personally 
than as one among the pleasant memories of the United States. The 
gift was accepted with great pleasure and many thanks. " 

Although indorsed by the most distinguished surgeons of the times 
and by a considerable clientele, Mr. Marks was not content with the 
durability of the leg which he was manufacturing. The improvement 
and perfection of his limbs were his theme, and how to make the leg 
stronger, lighter, and more comfortable was the problem that busied 
him for months and years. 

The principal part of the improved leg was made of wood. Sockets 
had been made of leather, supported by steel straps, and the fittings 
were made flexible and soft, but failed to prove either comfortable 
or durable. Every test pointed to the superiority of hard fittings, 
properly shaped. Adjustable sockets were for a while used for that 
part of the limb that came in contact with the flesh, similar to the 
methods still employed in France. Tightening straps and strings were 
calculated to admit of contraction or distention, to accommodate any 
change that might take place in the size of the stump; but these devices 
met with disappointment, and were sooner or later discarded. Tin, 
woven wire, steel strips, vulcanite rubber, papier mache, celluloid, and 
wood pulp have, from time to time, been tried, with the hope of finding 
a more suitable material than wood for sockets. G. W. Yerger 
obtained a patent from the United States in 1850 for a leg made of 
steel strips, padded inside to accommodate the stump. O. D. Wilcox 
obtained a patent from the United States in 1856 for an inner socket 
leg or a leg with a socket fitted to exactly the shape of the stump, that 
would occupy a place and be movable within the frame of the leg, — 
the same idea involved in the modern slip socket, — and, in 1858, the 
same gentleman obtained a patent for an end-bearing socket, which 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 21 

has since been purloined by a Philadelphia manufacturer. All these 
schemes for the substitution of wood for sockets and the structural 
parts of the leg have been faithfully tried and discarded, not once, but 
many times. The tests and experiments have brought confirmation of 
the fact that wooden sockets, fitted to accommodating shapes, are the 
lightest, healthiest, most durable, most pleasant, and most desirable, 
and that the elements of strength and lightness are more suitably com- 
bined in wood than any other material. It has likewise been proven 
that adjustable sockets are impracticable; that flexible sockets are pain- 
ful and unwholesome ; that metallic legs are objectionable ; that leather 
legs will foul and become offensive ; that rawhide legs will soften, col- 
lapse, and decay; that vulcanite legs are friable; that papier mache 
legs decay and are neither as light nor as durable as wood; and, upon 
the whole, that willow and linden woods make the best sockets, and 
are destined to maintain their supremacy for all time to come. 

In 1860 Mr. Marks became convinced that the durability of the ankle 
joint was not as great as it should be. Although it was calculated to 
withstand the strain of ordinary walking and toiling, yet every now 
and then some mishap or little thoughtlessness would bring some undue 
strain on the working parts and cause them to break or become loose. 
The renewal of the springs and screws, the loosening of the joints, the 
stretching of cords and tendons, became a source of great annoyance. 
It will be remembered that in 1860 the curing of rubber by Goodyear 
had become a practical success, and the material was being adapted to 
many purposes. The durability and elasticity of rubber, its impervi- 
ousness to moisture, and its thousand other excellent qualities made it 
a welcome commodity to many industries. Mr. Marks bethought him- 
self how he could apply that material to the construction of artificial 
limbs. He invented the rubber foot and attached it, with ankle articu- 
lation, to an artificial leg. The leg worked fairly well, but Mr. Marks 
was not satisfied that merely the substitution of rubber for wood in the 
foot would remove the embarrassing complications of the ankle. While 
he was studying over this matter, an old patron of his called upon him 
with original plans for an artificial leg. This customer had a long 
stump, extending almost to the ankle. The extremity of the stump 
was in a constant state of irritation, and would frequently suppurate ; 
the exudations were of such a nature as to destroy the ankle mechan- 
ism in every artificial leg he had ever worn. The foot which this man 
had planned was to be carved of wood and immovably attached to the 
leg socket. That this would be feasible was evident to him, as he had 
tightened up the cords in his ankle joint and blocked the motion so 
much that he was satisfied he could get along about as well on a leg 
with a rigid ankle as on one with a moving ankle ; and by connecting 
the foot immovably with the leg socket, he would provide ample room 
for the extremity of his stump, and would be rid of all the mechanism 
that so soon became disordered on account of the drippings from his 
stump. The leg was made according to his plans, and proved to be a 
success. The man walked surprisingly well and comfortably on the 
leg, although there was a slight stiffness noticeable in the foot, 



22 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

About this time, the artificial leg of the French prothetician, Count 
de Beaufort, was creating some commotion among European manufac- 
turers. The Count de Beaufort leg was nothing more nor less than a 
cheaply constructed leg, the foot and socket immovably attached, the 
foot only a semblance to the natural foot, with a rocker sole and not 





No. 510. No. 511. 

Count de Beaufort Legs. 



calculated to be covered by a shoe. The thought struck Mr. Marks 
that by attaching his rubber foot immovably to the leg socket, he would 
accomplish three great objects: first, the simplification of the con- 
struction of the leg by abandoning ankle-joint mechanism ; second, the 
removal of the stiffness noticeable in the foot which he had made to 
order for the customer with the long stump, and more or less notice- 
able in the Count de Beaufort leg, and third, the entire absence of the 
shock and jar that stumps receive from wooden feet at every step. 
This was the beginning of the construction of artificial legs with rubber 
feet. It was the beginning of an era in prosthesis, which the present 
time can boast of enjoying. This discovery, rather than invention, 
has brought untold relief and comfort to limb-wearers, and has more 
completely removed the disabilities of the cripple than any discovery 
the world has seen. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW TORK CITY. 



23 



THE RUBBER FOOT. 

The following cut, No. 512, represents the first rubber foot, invented 
in 1861 and patented in 1863. The dotted lines in the cut represent 
the limits of the wooden core, which was placed in the foot for the pur- 
pose of localizing the toe movement, affording the proper degree of 
compressibility at the heel and providing a medium for proper connec- 




No. 512. 

tion with the leg. The core was entirely surrounded with sponge rub- 
ber, with the greater quantity at the heel and toe. The rubber, being 
sponged, possessed a great degree of compressibility, and would yield 
under the weight of the wearer; so much so that when the weight was 
applied at the heel, the compression would be so great as to allow the 
toe to gracefully reach the ground. At the ball there was less rubber, 
so as to provide phalangeal support and the wearer be made conscious 
that there was something in front of his leg that would support him 
when standing, keep him from limping when walking, and act as a 
lever for propulsion. 

All the virtues of the rubber foot were combined in this model, so 
far as helpfulness in walking, safety, ease, comfort, and naturalness 
were concerned, but the foot was not as durable as the improved feet 
which have been devised since then. Those wearers who bore heavily 




No. 513. 



on the toes or were obliged to carry weighty articles, and subjected the 
front parts of their feet to severe and continuous pressure, would find 
the toes of their rubber feet becoming set and turned upward. When 
this was discovered Mr. Marks set about to improve the foot, and suc- 
ceeded in doing so in an admirable manner. Cut No. 513 represents 
the rubber foot as improved. In general construction the foot was the 
same as that which preceded it, differing from it, however, in the fact 



24 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



that the new foot was fortified at the toes by several layers of canvas 
which were chemically cemented to layers of rubber and attached to the 
front part of the block, extending forward to the ends of the toes. 

This foot has been properly called the "laminated foot." The pres- 
ence of the alternating layers of rubber and canvas gave the toes 
greater life, more resilience, and forced the foot to return to its proper 
shape with more certainty. Feet constructed on this plan were con- 
sidered for a number of years very close to perfection. It can readily 
be seen that the layers of rubber and canvas produced powerful forces 
that brought the toes back to their former lines and held them there. 
Every motion of the front part of the foot tended to make these layers 
travel on each other, and as they were held by elastic media, the 
forces of the energetic rubber were sufficiently powerful to restore the 
foot to proper lines. This feature of the rubber foot was patented by 
the United States, November 16, 1880. 

About sixteen thousand feet embodying the laminated toe feature 
were made and put into active use, many of which have been worn by 
patrons who resided in every habitable climate under the sun, and the 
consensus of approval exceeded anything that had been the inventor's 
most sanguine anticipation. 

September 17, 1895, the third improvement in the rubber foot was 
patented by the United States and abroad. 




No. 514. 



Cut No. 514 represents a sectional view of the new patented rubber 
foot, which may be described as follows : The body of the foot consists 
of a wooden core, as in previous models, the core is surrounded with 
sponge rubber of great porosity; a steel-spring mattress is floated in 
the rubber, nearer to the bottom of the foot than to the core, and a 
number of pneumatic air spaces are placed in the heel immediately 
above the mattress. The steel-spring mattress extending from the heel 
to the toes, unattached to the core, is composed of a series of spring- 
tempered steel strips imbedded in canvas, each having a pocket by 
itself, as represented in Cut 515. The steel strips are represented by 
letters A, A, A, A, A; the canvas providing pockets for the springs is 
represented by B, B ; C, C, represent metal tips on each end to keep 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



25 



the springs from creeping. This spring mattress, when floated in the 
foot, completely surrounded by rubber, provides additional resiliency 
for both the toes and the heel. Every movement of the foot, when in 
active use, permits pressure to be applied to the springs at either the 
heel, ball, or on the sides of the foot, forcing them to act. 




No. 515. 

The pneumatic chambers in the heel, between the spring mattress 
and the core, make the foot at that point more compressible. As the 
pneumatic chambers are separately surrounded by walls of sponge 
rubber, there is no danger of the foot collapsing and becoming inert, 
should the spaces become punctured. The danger of puncture and con- 
sequent collapse is a fatal objection to any form of pneumatic foot in 
which the walls depend, for their shape and resistance, entirely on the 
pressure of compressed air. 




No. 516. 



Cut No. 516 represents the new rubber foot with weight applied 
on the front portion, as it is when the wearer has advanced on 
the natural foot and is rising on the ball of the artificial foot. It 
will be seen that, on account of the weight being applied at the 
ball, the spring mattress is forced upward, and the sponge rubber 
is compressed above and below the spring mattress. It should also 
be noticed that this pressure pulls the spring mattress forward in 
the foot. These forces — first, the yielding of the spring, second, the 
compressing of the rubber, and third, the pulling of the spring mat- 
tress forward — form very powerful resultant forces that bring the 



26 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

foot back to its normal lines as soon as the wearer has advanced 
further in the step. The condition of the foot when under heel pres- 
sure, when the wearer has placed the artificial limb forward and 
applied his weight upon it, is somewhat the same, the spring mattress 
is forced upward ; the sponge rubber is compressed above and below 
the spring mattress ; the pneumatic chambers are flattened, and the 
spring mattress is pulled backward on account of its being deflected 
from a straight line. The compression of the heel permits the toes 
and front part of the foot to reach the ground while the shaft of the 
leg is considerably back of a vertical line. 







No. 517. 

As soon as the wearer advances so that the weight is vertically over 
the foot, the weight on the heel is lifted, and the foot resumes its 
natural shape, as shown in Cut No. 517. 




No. 518. 

Cut No. 518 represents the foot placed on an inclined surface. On 
account of the yielding quality of the rubber, the up-hill side of the 
foot will compress and accommodate itself to the incline and allow the 
foot to remain on its base. This is accomplished without a compli- 
cated mechanical lateral articulation. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



27 



The spring mattress not only forces the parts of the foot back to 
their proper shape, but removes all the exertion that is required to 
operate the antiquated articulated wooden foot ; at the same time the 
spring mattress re-enforces the front and back parts of the foot. 

The future will undoubtedly justify the claims for excellence and 
durability in this foot. 

Before the new patented foot was put into actual practical use, one 
was subjected to a test that established its durability beyond a doubt. 




No. 519. 



Cut No. 519 represents the device used for testing the durability and 
longevity of the foot. A represents the new improved rubber foot ; B 
represents the leg to which the foot is permanently attached; C repre- 
sents the floor ; D represents a lever, operated by power ; W represents 
the weight of 160 pounds, which is considered more than equivalent to 
the weight of the average laboring man. When power is applied the 
lever moves horizontally, forcing the leg forward and backward, first 
with the weight of 160 pounds applied to the ball of the foot and then 
with the weight of 160 pounds applied to the heel of the foot. This 
device was put into operation and permitted to run one thousand hours. 
The length of the stroke was equivalent to the average double step of a 
man. At the expiration of a thousand hours, calculation showed that 
the foot had been subjected to the same strain, wear, and service that it 
would if it had been walked upon by a man weighing 160 pounds, 
walking three miles a day, continuously for three consecutive years. 



28 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

The rubber fpot and its component parts were still in an unimpaired 
condition, and capable of undergoing the same test several times over. 

The impression that one receives on his first step on this new spring- 
mattress foot is pleasant and agreeable; especially so if the person has 
worn an artificial leg that was constructed with a wooden articulating 
foot. 

The action of the rubber foot has always been exceedingly natural, 
much more so than the flopping of the wooden articulating foot. It can 
readily be seen that any mechanism in the ankle of a foot that cannot 
be controlled by the mind or will must be more or less spasmodic, 
unreal, awkward, and mechanical. 

MOTIONS OF THE NATURAL FOOT AND ANKLE 
WHEN WALKING. 

That the movements of the rubber foot more closely approximate 
those of the natural foot in walking or running than the movements 
of the mechanical ankle joint can be ascertained by resort to instan- 
taneous photography. Photography discloses the fact that, when walk- 
ing and running, the range of motion in the natural ankle joint is 
extremely limited, and that the faster the man walks, the more abbre- 
viated is the range of motion, and that when the man is running, the 
ankle articulation is reduced to rigidity. The runner practically 
springs from the ball of one foot to the ball of the other. At all times, 
the natural movement in the natural foot is under absolute control of 
the intellect. The degree of tension given to the flexors and extensors 
is always governed by the speed with which the man moves and the 
conditions of the surface on which he is traveling. The eye telegraphs 
to the mind the peculiarities and conditions under which the foot 
should operate, the mind responds by commanding certain tendons 
and muscles to operate so that the proper resistance and stability, and 
the proper degree of mobility, will be accorded ; thus the man walks 
gracefully and with safety. If the co-ordination that exists between 
mind and muscle be destroyed, or in the least becomes impaired, the 
man becomes a paralytic, and it is absolutely impossible for him to 
walk with safety. A man with an artificial leg with mechanical ankle 
joint can be compared with the paralytic. Every time he places his 
foot on the ground he does so with fear and uncertainty, because there 
is no intellectual control over the movements of the foot. A pebble or 
an uneven surface will throw him off his equilibrium. With the rub- 
ber foot, which yields at the toe and heel, his movements are safe and 
sure, and the elastic media of rubber and springs gives the foot an 
apparent motion that destroys all stiffness or awkwardness. 

Watch a man walking on his natural feet at an easy gait. As he 
throws his left foot forward to take an advance step, he elevates on the 
ball of his right foot as shown in cut No. 520. He barely touches the 
heel of his left foot to the ground, when he gives his body an impetus 
with the ball of the right foot; see Fig. 521. The ball of the left foot 
does not reach the ground until the propulsion given by the right foot 



A. A. MAKKS, AKTTFICIAL LIMBS, NEW YOKK CITY. 29 



has carried the body nearly vertically over the left foot ; see Fig. 522. 
At this point, the right foot, having risen from the ground, is in the act 
of passing the left ; it being carried well in advance of the left, the heel 
is placed to the ground at the moment the left is well raised on the ball ; 
see Fig. 523, and the right foot rests flat on the ground when the left is 
elevated, and about to pass the right; see Fig. 524. This is repeated as 
the walking continues. 





It should be observed that, during those movements, the plantar sur- 
face of the natural foot is on the ground but a short interval, and 
only at such times as the body is nearly and directly over that foot. 
The cuts used to illustrate these five positions have been carefully pre- 






jno. 5.34. 

pared from instantaneous photographs taken of a man with natural 
feet, walking at a moderately rapid speed. They reveal very curious 
positions of the legs and feet, and do not appear very graceful or nat- 
ural, but they are nevertheless true, and present striking illustrations of 
the principles involved in the rubber foot. They show that with nat- 
ural feet there are times during the process of walking when the heel 
only is on the ground, and times when the toes only are on the ground, 
and that the plantar surface of the advanced foot* does not reach the 



30 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

ground until the body is nearly or directly over it, nor does the plantar 
surface remain on the ground for more than a brief interval, as almost 
the very moment the body passes a vertical line, the tendo-Achillis is 
contracted anr. the body rises on the ball of the foot and the heel rises 
from the ground. It will be well for the investigating mind to care- 
fully study these pictures and note the peculiar position in which the 
feet are placed at the various stages of the step. 

Now, imagine that one of the legs is artificial, with a moving ankle 
joint that will admit of the plantar surface of the foot being fiat on the 
ground from the moment the heel touches to the moment the toe rises. 
Photographs taken of a foot constructed in that manner, at the various 
intervals during the step, will show a marked contrast to the pictures 
above. A person wearing an artificial leg with an articulating foot 
will walk somewhat in the following manner : advancing on his arti- 
ficial leg, he strikes the heel to the ground, and the moment he applies 
weight to that leg, the toes immediately drop witb a thud and the 
plantar surface of the foot remains on the ground during the entire 
interval that the body is passing over the foot, and when the body has 
passed forward of the foot, the heel still remains on the ground, and the 
wearer has to use supreme effort in order to spring from that foot, as 
he receives no assistance from the ball. This exertion is not only an 
additional tax, but produces an awkwardness and limp that are con- 
spicuous and make the fact apparent that an artificial leg is being 
worn. 

Some makers of the ankle-joint leg claim that they remedy this diffi- 
culty by tightening the heel cords, thus making the ankle joint prac- 
tically rigid; but no means have ever yet been devised that will admit 
of tightening the heel cord and keeping it so permanently. The heel 
cord, under the enormous strain, will invariably stretch or break. 
When the heel cord is tightened, the conditions are unquestionably 
improved, and the foot assumes the action and operation of a rigidly 
attached foot. Now, if the conditions are improved by having the 
ankle motion limited by the tightening -of the heel cord, why is it 
not an advantage to attach the foot permanently ; depending on the 
elasticity of rubber in the foot to avoid concussion, and thus dispense 
with a mass of heavy, complicated, unreliable, treacherous, and 
needless machinery ? 

Having made plain (he movements of the natural foot in walking, 
and having contrasted the movements of the mechanical foot, let us 
study for a moment the movements and action of a sponge rubber foot 
attached to the leg socket, without ankle articulation. The wearer 
advances on the rubber foot, he touches the heel of the rubber foot to 
the ground, and, as he applies his weight to that side, the sponge rub- 
ber in the heel compresses sufficiently to allow the advance on the ball 
of the foot to be made smoothly and gracefully. He rolls on the ball of 
the foot without any effort whatever, receiving a great amount of 
assistance from the rocker bottom of the wooden core inside of the 
rubber foot and the steel-spring mattress floated in the foot. The 
moment the heel is relieved of weight, the elasticity of the rubber and 



A. A. MAEKS, ARTIFICIAL LIMBS, NEW YORK CITY. 31 

the resiliency of the spring mattress force the rubber heel back to its 
proper shape. The toes bend at the proper place, and the wearer 
completes the step without effort or a perceptible limp. 

A comparison of the two methods, with and without ankle joints, in 
artificial legs, shows that with the artificial ankle joint the interval that 
the plantar surface rests on the ground is very much greater than that 
of the natural foot, while with the rubber feet the interval is approxi- 
mately the same, or a trifle less ; thus, by means of the rubber foot* a 
more natural action is obtained and a vast amount of mechanism 
dispensed with. 

It is impossible to overestimate the value of mental forces in control- 
ling the actions of the natural ankle joint, and when these mental forces 
become inert, as they necessarily must in artificial joints, the embar- 
rassments that follow are very great, as in locomotor ataxia, in which 
the afflicted walk by placing their feet almost entirely by the sense of 
sight. It is easy for a person to appreciate the merits possessed in the 
immovably attached foot when comparisons, as above, are indulged in. 

It is the experienced man, the man who has experimented with both 
kinds of limbs, who appreciates the principles involved in the rubber- 
foot discovery. It is the experienced man who comprehends the reason 
why the wearers of artificial limbs with rubber feet walk farther, faster, 
and with less fatigue, than those walking on ankle-jointed wooden feet. 

In running the contrast is still more striking ; for, with either the 
rubber or natural foot, the entire plantar surface is never on the 
ground. It is the heel-and-toe touch to the ground that distinguishes 
the fast walker from the runner. Eunning is the act of springing 
from the ball of one foot to the ball of the other. With the ankle- 
jointed foot, running is exceedingly awkward and unnatural. The 
movement in the ankle impedes celerity. When standing, the immov- 
ably attached rubber foot furnishes a large base on which to balance; 
hence, a man with two artificial legs with immovably attached feet 
can stand restfully and safely without assuming awkward and unnatural 
positions. 

The rubber foot affords the laborer a substantial substitute with 
which to support and brace himself when working at the bench, or on 
the road, on the farm, or at whatever occupation he may be engaged 
in. There are no uncertain or treacherous movements to hamper him 
or make his position uncertain ; his support is adequate and positive. 

One of the patrons of the rubber foot, a painter by occupation, 
claims that with the rubber foot he can climb a ladder, stand on a scaf- 
fold and balance himself at any elevation with absolute safety. With 
an ankle-joint leg he would feel tottlish, and, when on a ladder, would 
have to depend more on the grasp of one hand than on his foot ; but, 
with the rubber foot, his base is substantial and reliable. 

A farmer who toils in the field can plod along over stony or muddy 
ground on a rubber foot with safety. The accumulation of mud on his 
shoes does not cause his toes to drop and trip him. Uneven surfaces 
will not throw him from his balance or produce violent jerks to his 
stump. 



32 A. A. MAEKS, AETIFICIAL LIMBS, NEW YOEK CITY. 



THE COST OF WEARING. 

The greater number of artificial-limb wearers are poor persons. It is 
an exception to find a wealthy or even a well-to-do man in need of an 
artificial limb. It is the poor man, the wage-earner, the laborer, the 
man that works in the mill, the engineer, fireman, or brakeman on .the 
railroad, the miner working in the gangways and breastworks, and the 
privates in the army, whose occupations place them in jeopardy, and 
who are exposed to the dangers which destroy life or mutilate the body. 
This being a fact, it is all the more important that artificial limbs 
should be made that are absolutely durable and inexpensive to wear. 
The first cost, that of purchasing the limb, should be the only impor- 
tant item that the wearer should provide for. An artificial leg or arm 
that is constructed with delicate machinery or parts subject to friction 
is not objectionable for a showcase, but is ill-suited to the wants of the 
man who has to support himself and family by daily toil. The loss of 
time in having repairs made, the cost of repairs, and the dangers of 
breaking down at critical times are serious matters, and the careful man 
should take these matters into consideration before he decides what 
make of limb to buy. We do not know of an artificial leg with an 
ankle joint that is now made or that ever has been made, and we doubt 
that there ever will be one made, that will not cost from five dollars 
to twenty-five dollars a year to keep in repair. The delicacy with 
which an ankle joint must be constructed in order to be light, and the 
immense strain that the ankle must resist when the leg is subjected to 
severe strains, are conditions that are antagonizing to durable ankle 
mechanism. The experience of an old patron with an ankle joint, as 
told in previous publications, is worthy of repetition here, as it but 
repeats the experience of thousands of wearers of artificial limbs with 
articulating feet. 

" I started from my house one morning to meet a pressing engage- 
ment. I had not gone far, when the ankle-joint of my leg became 
noisy, and squeaked. My first impulse was to disregard it, but the 
noise increased, and I was fearful that I might attract attention, so I 
entered a drug store, where I had a passing acquaintance, and asked 
the proprietor to admit me to his prescription room, and furnish me 
with some oil and a screw-driver. It took about one hour to disjoint 
the foot, lubricate the working parts, and reconnect them. I resumed 
my journey and got but a short distance, when I made a false step on 
the toes of my artificial foot and broke the heel cord. This, of course, 
occurred at a moment when I was bearing heavily on the toes, and the 
breaking of the heel cord allowed the leg to pass so far forward that 
the lower part of the leg became very badly splintered. Of course, I 
was helpless in this condition. I hailed a carriage, and with the 
assistance of a passer-by, I succeeded in hobbling to and getting in the 
vehicle. The thoroughfare at which this happened was a thickly trav- 
eled one, and the collection of persons, who looked upon me piteously, 



A. A. MIRKS, ARTIFICIAL LIMBS, NEW YORK CITT. 33 

added much to my embarrassment. Instead of pushing on to meet 
my engagement I dispatched a message of explanation, and directed 
the driver to take me to my home. There I was obliged to remain 
three long days until my artificial leg could be repaired and returned 
to me." 

The recurrence of incidents of this kind is certainly enough to dis- 
tract anyone, and to force any conscientious manufacturer into the 
adoption of more simple and durable methods of construction. The 
absence of ankle mechanism removes the possibility of the foot becom- 
ing loose, disjointed, or in any way treacherous. 

The fact that persons walk, run, and perform all kinds of labor on 
artificial legs with rubber feet immovably attached, is certainly evi- 
dence that the ankle mechanism is entirely useless. Men, women, 
and children with rubber feet run, walk, skate, dance. Performances, 
regarded not many years ago as impossible, are daily being performed 
with facility. The farmer follows his plow on a rubber foot, the 
blacksmith works at his forge on a rubber foot, the sailor climbs the 
rigging, the builder erects houses, and persons of every vocation 
attend to their affairs with little concern and hindrance; accomplishing 
as much labor, earning as much wages, and living as happy lives as 
others of their associates who are in possession of all their natural 
limbs. 



WEIGHT, ODOR, AND THE EFFECTS OF TEMPER- 
ATURE ON RUBBER FEET. 

Some of our competitors, more unscrupulous than truthful, have 
circulated the report that artificial legs with rubber feet are heavier 
than those with wooden feet; that rubber emits a disagreeable odor, 
and that, on account of changes in the weather, the rubber becomes 
hard and crumbles, and a thousand other equally absurd criticisms. 
All these statements are made without fact or foundation. They are 
only calculated to bias the mind capable of being influenced, and to 
divert attention from the merits of the rubber foot — in short, a business 
ruse, a trick, a deceit. In the first place, artificial legs with rubber 
feet are lighter than artificial legs with wooden articulating feet. The 
absence of metal parts, such as springs, joints, and cords, removes the 
greatest bulk of weight, therefore, artificial legs with rubber feet with- 
out these metallic parts can be lighter than artificial legs with wooden 
feet and metallic parts. The sponge rubber used in feet that are made 
at the present time is not as heavy as wood, therefore, the substitution 
of rubber for wood causes an additional reduction. in weight. 

We have removed wooden articulating feet from artificial limbs in 
hundreds of cases and substituted them with rubber feet. In every 
instance of which we have a record, the weight of the leg has been 
diminished from one to eight ounces, and this reduction of weight has 
been made at the extremity of the leg, where it is mostly felt. 



34 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

The second statement is equally false, that there is a disagreeable 
odor that emanates from the rubber foot. That this is false is apparent, 
as sponge rubber is as odorless as wood; besides the rubber foot is 
covered with air-and-water-tight material and surfaced with a water- 
proof enamel. Should the rubber possess any disagreeable odor, it 
would not be possible for that odor to escape. 

On the other hand the ankle joints of articulating feet have to be 
oiled very frequently, the oil in time becomes rancid, and the odor of 
rancid oil cannot be tolerated by one of refined senses. 

The third statement can also be contradicted, as pure gum, properly 
vulcanized, will neither deteriorate nor undergo any change in its con' 
sistency or elasticity, by any changes of temperature that the human 
body is capable of surviving. It requires 280 Q Fahrenheit of ^temper- 
ature to produce any change in rubber, and as there is no habitable 
place on the face of the earth with a temperature very much above 
100°, the foot is never placed in danger on account of heat, as no 
human being could live in a temperature intense enough to affect 
rubber. 



THE WEIGHT OF AN ARTIFICIAL LEG. 

The weight of an artificial leg may be said to vary from one pound 
to seven pounds, according to the amount of material required to make 
it of proper size and of sufficient strength to meet the needs of the 
wearer. We have applied artificial legs to children less than one year 
old. The artificial legs applied would not weigh over a pound, but 
modern Goliaths who weigh from two hundred to three hundred 
pounds, and engage in heavy, laborious occupations, must have artifi- 
cial limbs that will weigh from six to seven pounds, in order to have 
requisite strength. The only way to obtain strength is by the employ- 
ment and proper disposition of suitable material, therefore a small leg 
is not as heavy as a large one, and a strong leg must be heavier than a 
weak one. A leg with a rubber foot can be made from six to sixteen 
ounces lighter than any other kind, on account of the absence of 
heavy, metallic ankle machinery. 

The ideas of those wearing artificial legs, in regard to weight, cannot 
be taken as a criterion. Some say, " Make my leg as light as possible, 
even if you have to sacrifice strength." Others say, "Do not make 
my leg too light ; I have worn light and heavy legs, and I find that T 
can walk more steadily and step more naturally with a leg of moderate 
weight than with one extremely light. I like to have my leg act as a 
pendulum, so that when I raise it from the ground, after taking a step, 
the weight of the leg will be sufficient to cause it to swing forward and 
ahead of the center of my body, without requiring assistance from my 
stump." Others say, " I do not care what the leg weighs, as long as it 
is made strong; strength is the greatest consideration. If the leg 
weighs a pound or two more I will not object to it, as I can soon get 
used to that, but the leg must be strong and last a long time, as I am 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 35 

poor and cannot afford to take chances on the leg breaking or wearing 
out." It will thus be seen that the opinions of "wearers are at variance 
and cannot be depended on. 

We must confess that the demand of the vast numbers of those 
wanting artificial limbs is for the lightest leg that can be produced, 
even at the sacrifice of strength and durability. For such persons legs 
are made extremely light, with the smallest possible margin of safety. 
For light, delicate ladies weighing less than one hundred pounds, a full- 
length leg weighing three pounds, without attachments, is as light as 
it is possible to produce. A leg made as light as that, and having suffi- 
cient strength, is almost a marvel. We know of nothing produced in 
mechanism calculated to withstand the same strain that has so little 
weight; a leg weighing six pounds for a large, heavy person, one who 
is likely to subject the leg to severe use, is not excessive, and should 
not be complained of. Let us think for a moment of the weight of 
other instruments that are not calculated to withstand greater or 
severer strains. The bicycle has had its weight reduced from sixty 
pounds to nineteen, and it is generally conceded that a nineteen-pound 
bicycle is as light as prudence will allow, and persons marvel at a 
bicycle weighing so little ; yet the nineteen- pound bicycle has no more 
work to perform, is not subjected to any more strains than an artificial 
leg weighing from three to six pounds. The bicycle, as well as the leg, 
has only to support the superincumbent weight of the rider and resist 
such strains as they are occasionally subjected to. We have known 
women to complain about the weight of an artificial leg that actually 
weighed less than four pounds who would not groan under the weight 
of an eight- or ten-pound gown. We have actually seen women with 
gold and silver smelling bottles, lorgnettes, chatelaines, bangles, and 
trinkets suspended from their slight waists and suffer no inconvenience 
from the burden, and at the same time express a wish that their three- 
and-a-half-pound artificial leg might be made lighter. 

The maker of an artificial leg must construct a leg that will not only 
sustain the weight of the wearer, but that will not break under such 
strains as the leg is likely to receive from time to time. If a person 
slips and recovers himself with his artificial leg, some part of that leg 
receives a strain that is much greater than the weight of the wearer. 
A person ascending or descending stairs subjects his artificial limb to 
greater strains than he does when he is walking on a level. The leg 
must be made strong enough to meet these demands, and besides 
that must have a margin of strength that will enable the wearer to 
carry such articles and lift such weights as his vocation or necessity 
may require. No matter how crippled a person may be, and no 
matter what station in life a person may occupy, and no matter how 
delicate the person may be, there are times when that person will find 
it necessary to lift, carry, push, or pull some weighty object, and 
subject his artificial leg to more strain than merely walking upon it. 

It is not wise to build an artificial leg so close to the danger line 
(especially when made for a delicate person) that when that person 
becomes well, stronger, and heavier, the leg will crush. Conditions 



36 A. A. MAEKS, ARTIFICIAL LIMBS, NEW TOEK CITY. 

do not always remain the same. ' ' The weak of to-day are the strong 
of to-morrow." The. light person frequently becomes heavy, and the 
wise limb-maker will keep on the safe side ;, otherwise he will place his 
reputation in jeopardy. 

The average weight of a substantial artificial leg suitable for a thigh 
amputation, to be worn by a man of average size and weight, engaged 
in an ordinary occupation and possessing the requisite strength, may 
be placed at five pounds, and less when for a leg or foot amputation. 
The location of the weight of a leg has much to do with the apparent 
weight ; thus, a leg weighing six pounds can be so constructed as to 
feel lighter than one weighing half as much. Flimsy, insecure, and 
inadequate means of attachment to the body will make the leg feel 
much heavier than it really is. A heavy foot with a light thighpiece 
produces an apparently heavy leg, because the foot is distant from the 
stump and is weighty, and the thighpiece is light, flimsy, and does 
not hold the leg to the stump securely. On the other hand, a leg with 
a light foot and a strong, substantial thighpiece, which properly 
secures the leg and holds it in place, reduces its apparent weight con- 
siderably. 



HOW LONG WILL AN ARTIFICIAL LEG LAST? 

The question is frequently asked, ' ' How long will an artificial leg 
last ? " Our reply is invariably, "That depends upon the care that is 
given to it." We have patrons who are still wearing artificial legs that 
were made for them over twenty-five years ago, and the legs appear to 
be in fair condition at the present time, but these are exceptional 
cases and should not be held up as a criterion any more than should 
the experience of some who, through abuse and carelessness, destroy 
then artificial limbs in unexpectedly short times. An average made of 
the frequency with which our patrons renew their substitutes, fixes the 
period at about eight years. This does not imply that a leg will not 
last longer than eight years. Renewals are often made not from 
necessity but from choice ; the wearers want new legs the same as they 
want new coats, before the old coats are completely gone. Artificial 
limb- wearers become as proud of their artificial limbs as they do of any 
article of apparel, and those of abundant means frequently supply 
themselves with several, so as always to have one in reserve to meet 
an emergency. Accidents are as likely to occur to artificial limbs as 
they are to natural limbs. Men have fallen under vehicles and have 
been fortunate enough to have their artificial legs crushed instead of 
their natural ones. When accidents occur to artificial legs, they are 
removed from the body and sent to the manufacturer for repairs. 
The wearer who is fortunate enough to have a duplicate artificial leg 
is certainly at great advantage. Taking all these facts into consider- 
ation, and fixing the average life of an artificial leg at eight years, is 
certainly placing the estimate within the limit. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 37 

The United States Government, with great liberality, has fixed the 
periods for issuing of artificial limbs to pensioners at three years. 
This is done wholly as a gratuity, not as a necessity. 



STOCKINGS AND SHOES. 

All artificial feet should be dressed with stockings and shoes, the 
same as natural feet. The wear and tear on shoes and stockings, when 
the feet articulate at the ankles, are enormous, and have been a 
source of complaint by many wearers. This annoyance is entirely 
removed by the use of rubber feet ; besides that, shoes on rubber feet 
always look like shoes worn on natural feet, as the wrinkling at the 
toes and other parts is the same. We have heard patrons say that in 
five years their rubber feet have saved them in the cost of stockings 
and shoes a sum of money nearly sufficient to buy a new leg. 



FITTINGS. 

Ease and comfort in wearing an artificial leg or arm can only be 
obtained by means of proper fittings — no matter how well the limb 
may be constructed, or with what nicety all the parts operate, the limb 
is worthless if it causes pain to the wearer, chafes the stump, or excites 
irritation. The art of fitting an artificial limb is something that 
cannot be obtained by any mechanical methods. A thorough knowl- 
edge of the anatomy of the stump, the causes and effects of pres- 
sure here and there, the importance of non-interference with the circu- 
lation, and how to provide a fitting that is comfortable and that will 
not interfere with circulation or displace the tissues on the stump, is 
something that can only be acquired by experience, judgment, thought- 
fulness, and conscientious study. 

There are a great many artificial-limb manufacturers in the world, 
but there are very few fitters. Limbs that look very nice in show 
cases may please the eye, but limbs that are skillfully fitted are the 
only ones that will please those who are to wear them. 

Every conscientious manufacturer knows that there is but one way 
in which to fit a limb, and that is to excavate a block of wood until the 
excavation is of proper size and shape to receive the stump comfortably 
without compressing the blood vessels or drawing the tissues over the 
extremities. A properly fitting socket is entirely different in shape 
to the stump which it is calculated to accommodate — a plaster cast 
of a stump and a plaster cast of the inside of the socket that fits that 
stump are no more alike than the last on which a shoe is built is like 
the foot on which that shoe is to be worn. The inside of a socket is 
provided with channels for the accommodation and protection of 
exposed bones, and provided with hollows for the accommodation 
of sensitive prominences. These channels and hollows are accentua- 
tions of the parts of the stump that are delicate and that will not 



38 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

admit of pressure. It is absurd to assume that if a cast is made of the 
stump and any plastic material, such as leather, felt, rubber or metal 
is formed on that cast, that a comfortably fitting socket will be 
obtained. Sockets made that way are always irritating", and a source 
of much pain and suffering. Even the cutting out of a block of wood to 
the counterpart of a plaster cast of a stump, is productive of unsatisfac- 
tory results. It is the novitious artificial limb-maker who blunders into 
errors of this kind, and it is the brainless wearer of artificial limbs who 
permits himself to become beguiled into this way of obtaining a fitting. 
If a plaster cast of a stump could be depended upon as a safe guide, 
the process of fitting artificial limbs would become greatly simplified, 
and instead of employing high-priced fitters, the work could be done 
by inexpensive apprentices, who would have only to place plastic 
material on a form, or to attend and feed a fitting machine. 

There are irregular- form turning lathes, as all mechanics know, that 
are capable of carving out a block of wood so that the interior of the 
block will have the exact form of a model which is placed in the lathe. 
We have seen these machines in operation, and would hail with 
delight the opportunity to use them in our work, if plaster casts or 
molds could be used for models. By such means the matter of fitting 
would be reduced to a mechanical process, as the machine would auto- 
matically follow the model and excavate the block of wood accord- 
ingly ; but, unfortunately, a plaster cast is not a safe guide, and, when 
used, it must undergo some alterations which none but the skilled fitter 
is competent to make. The same skill and labor and judgment neces- 
sary to modify the cast can be applied to the excavating of the block 
directly, and the same results will follow, with less labor and more 
certainty. 

When we consider that the composition of the stump is but bone* 
covered with muscles, fat, blood vessels, nerves, tendons, and skin, and 
that these components are not uniformly distributed over the bone, 
and that they are soft, yielding, and easily displaced, and further, that 
where the nerves are less sensitive more pressure can be applied, 
and where they are closer to the surface and more sensitive less 
pressure can be applied, we will readily see that a socket made to fit 
that stump properly must permit pressure to be applied, not generally 
or uniformly, but only on parts of the stump that will endure pressure 
without producing pain. We will also see that the vascular parts of the 
stump must be subjected to no pressure whatever ; for, if the veins are 
constricted, the stump will become strangulated, and if the arteries are 
constricted the stump will be insufficiently nourished. For these 
reasons it is obvious that artificial legs should be fitted only by persons 
skilled in the work, who know the location of large blood vessels, the 
character and disposition of the nerves, and who attach importance to 
the necessity of avoiding pressure on the vascular parts. A man who 
has this knowledge and judgment is competent to fit an artificial leg, 
and he is the only one who should be intrusted with such delicate work. 
The skilled fitter does not always need the presence of the person who 
is to wear the leg he is fitting. Circumferences and, diagrams, of the 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 39 

stump are sufficient guides for him. With these data, he can do more 
for the comfort of the wearer who lives at a distance and cannot leave 
his home than it is possible for incompetent fitters to do with plaster 
casts, or even with the presence of the wearer. 

We do not wish to be understood as discrediting plaster casts. Casts 
are useful in some cases and are useless in others. Carefully made 
casts will of course convey the contours of the limb and will locate 
irregularities, prominences, and tender spots. Plaster casts are always 
necessary when persons are to have artificial limbs fitted in their 
absence, who have stumps that extend to the knee joint or ankle joint, 
or a partial foot stump or elbow joint, wrist joint, or partial hand 
stump; but, generally speaking, stumps that extend to any point 
between the articulations do not require to be reproduced in plaster. 

The advantages of wood sockets can be more fully appreciated when 
the facts above presented are understood. A wood socket always 
retains the shape that it receives from the skillful fitter. No matter 
what may be the condition of the weather or the condition of the 
stump, the socket is always the same. A leather or padded socket, or 
any socket that is soft and yielding, will lose its character from wear, 
soften from the heat and moisture of the stump, and will change in 
shape from a socket that protects tender spots to one that will possess 
the exact shape of the stump, and that will apply pressure uniformly 
about the stump, or, in other words, that will press tender and sensitive 
spots equally as severely, as the places that are capable of enduring 
pressure. These disadvantages of leather, or pliable material of any 
kind, are thus made apparent. 



CHANGES THAT TAKE PLACE IN A STUMP AFTER 
A LIMB HAS BEEN APPLIED. 

It is absolutely impossible for a limb manufacturer to anticipate and 
provide for changes that the wearing of an artificial leg may produce 
".n a stump. He may look for some general change, but it is conjectural, 
and he cannot provide for them. 

We have a great many patrons whose stumps have never changed 
from the moment they applied their artificial limbs years ago. We 
also have patrons whose stumps have grown larger, and we have many 
patrons whose stumps have emaciated and become very much smaller. 
Much depends upon the disposition of the person, his occupation, and 
habits. Generally speaking, there is a tendency for stumps to become 
smaller, on account of the pressure due to the wearing of artificial limbs 
and the activity that artificial limbs force upon the stumps. , When 
stumps reduce, artificial limbs fail to fit snugly, and it is necessary to 
put some form of lining in the sockets of the limbs or wear a great 
number of coverings on the stumps. In cases of great shrinkage, — so 
great that the wearing of many coverings on stumps or fillings in 
the sockets produce discomfort, — the best remedy is to have the sockets 
removed from the legs and new ones put on. 



40 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

In order to minimize these possible changes, it is always well to 
bandage the stump tightly, and keep it bandaged, from the time the 
stump is healed until an artificial limb is applied. While bandages 
may or may not reduce the size of the stump, they will keep it from 
becoming swollen or edematose. We cannot promise that all the 
changes that may take place in a stump can be brought about by band- 
ages. If the stump is one that will yield and become smaller under 
bandages, it is very likely to yield and become still smaller under the 
pressure of an artificial limb. 

Sometimes the question is asked, " Is it not a good plan to bandage 
a stump tightly, and reduce it as much as possible, before applying an 
artificial limb? " We always reply to this question in the affirmative, 
and urge the use of bandages for a few days as an experiment. If it 
is found that the bandages produce any reduction in size, then continue 
the use of bandages until the reduction ceases. If no apparent 
changes are brought about by two days' bandaging, it is safe to con- 
sider that bandaging is useless, and an artificial leg can be applied 
immediately. 

It is not always comfortable to bandage a stump. It is hard to keep 
bandages on short, flabby stumps, and the attention required to take 
them off and tighten them and put them on very frequently, is con- 
siderable. After considering the matter in all its lights, we are 
thrown in doubt as to whether it is economy to postpone the appli- 
cation of an artificial limb for weeks or months, with the hope 
of bringing about a reduction in size, in order to save the trifling 
expense of a new fitting. As the expense of a new fitting is 
very small, will it not be more economical in the end, and w T ill it 
not contribute more to the comfort and happiness of the patient, if an 
artificial limb is applied to his stump as soon as it is healed, and the 
patient has regained enough strength to get about on crutches ? By 
this means he will learn to walk at an early date, will be able to dis- 
pense with the use of his crutches, will have his stump thoroughly 
protected from injury, will be able to go about and take healthful exer- 
cise and attend to such duties as his occupation may demand ; then, *f 
at the end of a few months his stump has shrunken, and it is deemed 
advisable to provide a new fitting, let him pay the small amount and 
have a new socket applied to the limb. It certainly seems to us that 
the use of an artificial limb for the length of time that it takes to 
reduce the stump, the healthful exercise that the wearer will obtain, 
and the time that he will be able to give his occupation will more than 
offset the cost of a new socket. A new fitting may be considered as 
the final one, and will answer for many years. 

REQUIREMENTS. 

The requirements of an artificial leg which are most essential are as 
follows : First, fittings and adjustments that do not abrade, strangu- 
late, wrench, or twist the stump ; second, articulations that approxi- 
mate nature, that aid propulsion, that are noiseless, durable, safe, and 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 41 

not superfluous; third, minimum weight and maximum strength; 
fourth, naturalness in appearance ; fifth, durability. 

Not one of these requirements can be sacrificed with prudence. 
Each requirement is fully discussed in the pages of this book. 

We claim to have combined all of these requirements in the most 
scientific manner. 

The substitution of the India rubber foot for the wooden foot has 
simplified the construction of the leg, and has made it possible to 
discard much intricate, heavy, noisy mechanism. The value of this 
substitution cannot be overestimated. A soft, yielding medium to 
stand, walk, or run upon, must be admitted as superior to the heavy, 
harsh, mechanical foot which jars the stump and exasperates the 
wearer. 



RUBBER FEET WITH ANKLE JOINTS. 

Although we have the strongest preference for artificial legs with 
rubber feet permanently attached, and feel that our experience, obser- 
vation, and study sustain us in our opinion, we do not permit ourselves 
to stand in the way of applicants having artificial legs constructed 
upon plans that are more to their choice. 

We frequently hear that So-and-so would buy of us if we would furnish 
rubber feet with articulatiug ankles. The idea of the rubber foot is 
acceptable, but rigidity at the ankle is doubtful. We know that there 
are persons who have become inured to articulating feet, and who do 
not care to change to artificial legs with "stiff ankles"; that the 
element of doubt frequently hinders them from trying rubber feet. 
Although they are willing to assent to the fact that the advantages of 
rubber over wood are many, they do not care to take chances on rigid 
ankles. We are disposed to accommodate persons who have fixed 
preferences, and will make for them artificial legs with rubber feet 
that articulate at the ankles, when so ordered. 

A rubber foot articulating at the ankle is far superior to a wooden 
foot articulating at the ankle ; and while we consider that a non-artic- 
ulating foot is the best of all, we will not obtrude our opinion or choice 
beyond the reasonable limit. 

If, therefore, a customer desires to have his artificial leg constructed 
with rubber foot articulating at the ankle, we will construct a leg that 
way for him, upon his request. Prices are the same, whether rubber 
feet are permanently attached or made to articulate. We will do 
more than this : in order to relieve the patient of all risks, we will 
make an artificial leg with rubber foot permanently attached, and if 
within one month the wearer feels convinced that he would prefer an 
articulating foot, we will change the leg so that the foot w r ill articulate, 
and will make no additional charge for making that change. 



42 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



DESCRIPTIONS OF ARTIFICIAL LEGS SUITABLE FOR 
THIGH STUMPS. 

The structural parts of an artificial leg suitable for a thigh stump 
may be described as follows : The thigh and leg sections are made of 
tough and light willow or basswood. They are shaped to approxi- 
imately the size and contours of the companion or natural leg. The 
thigh section is excavated to proper shape and size to accommodate the 
stump, permitting pressure to be applied only at admissible places — 
about the sides of the stump, distant from the extremity, and about the 
ischial and perineal regions. The lower section of the leg is excavated 
in order to reduce weight, the upper and lower sections are connected 
by an articulating joint, which is capable of adjustment as hereinafter 
described. The lower section is permanently attached to the rubber 




foot. The upper and lower sections are covered with raw hide in order 
to obtain strength, the foot is covered with flexible calfskin, the entire 
leg is enameled with a flesh-tinted preparation that not only ornaments 
the leg but makes its surface waterproof. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



43 



Cut No. 525 represents the usual form of an artificial leg for a thigh 
stump. This leg is held to the stump by means of suspenders which 
pass over the shoulders or about the body. Suspenders are described 




No. 528. 



under their proper headings. Before the stump is inserted in 
the socket, a soft woolen or cotton sock is drawn over the stump, 
which not only provides a pleasant medium between the stump and 



44 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



the socket, but provides an absorbing material which takes up the per- 
spiration from the stump, keeps the stump in a healthy condition and 
the socket free from fouling. The knee mechanism of this leg can be 
better understood by referring to the following cuts. Cut No. 52B 
represents that section of the thigh and leg that contains the knee 
mechanism. The parts are together, as they are when in use. Cut 
No. 527 represents the two parts separated, and Cut No. 528 represents 
the different parts used in the connection. 




No. 529. 



A represents the T-joint, which is attached to the thigh piece at its 
base. The two arms of the T work in journals made in the leg section. 
B, B, represent the cap screws; C, C, caps; D, spring piston; E, spiral 
spring; F, cylinder, andG, the three parts of the spring, namely, piston, 
spring, and cylinder placed together. The T-joint, A, has the shape of 
an inverted T, hence its name "T "-joint. The joint is made of tough 
gun steel, forged from one piece of metal and turned on the lathe. 
When the leg and thigh sections are placed together, the arms of the 
T-joint rest in boxes and are held there by two hard wood caps, C, C, 
which are secured by long steel screws, B, B, which depend for their 
holding on steel nuts that are imbedded in the leg. 



A. A. MAEKS, ARTIFICIAL LIMBS, NEW YOEK CITY. 



45 



The wearer has command over this joint ; he can tighten or loosen 
the bearings at will, and have the joint work snugly or loosely, as he 
may choose. The pressure of the caps on the joint can be regulated by 
the screws, and thus any desired tension on the articulation can be 
made. This knee mechanism also admits u taking-up" for wear, and 
thus avoiding any rattling or noise that would result from attrition. 

The small steel lever with ball on end, projecting from the back of 
the joint, operates in the cavity of the hard wood piston, D ; the piston 
is inserted in one end of a steel spring, E, which has its lower part 
encased with leather and then placed in a drawn metal cylinder, F. 
The lower convexed end of this cylinder is received in a bridge placed 
in the interior of the leg in the region of the calf. The operation of 




No. 530. 



the spring is twofold ; it urges the lower leg forward in walking, and 
holds it back at full flexion when sitting. This is accomplished in the 
following manner: When the leg is extended, the point of pressure is 
applied to the end of a steel lever, which extends about an inch back- 
ward of the center of motion in the knee. This lever revolves with the 
joint; when the leg is at full extension this lever projects horizontally 
backward, and the spring presses on a ball at its extremity holding 
the leg at extension. Cut No. 529 represents a sectional view of the 
leg at full extension. Cut No. 530 represents the leg partially bent. It 
will be seen in this position that the end of the lever has been carried 
around to a neutral point, when the spring neither urges flexion nor 
extension; but when the knee is flexed still more, as shown in Cut 
No. 531, the lever has passed forward of the neutral line and the spring 



46 



A. A. MAEKS, ARTIFICIAL LIMBS, NEW, YORK CITY. 



forces the ball upward, urging greater flexion ; and when the flexion is 
at its limit the leg is kept in that position by the spring; thus the 
objection to the ordinary spring knee articulations is entirely removed, 
that objection being the tendency for the leg to fly out when the wearer 
is sitting and unguarded. 

The power of the spring in the knee can be increased or diminished 
from time to time. If it is desired to increase the power a little pack- 
ing can be tamped in the cylinder, and if it is desired to diminish the 
power, a ring or two of the spring can be cut off.' If the wearer does 
not want a spring in the knee, he can remove it himself. He will not 
be required to disjoint the leg in order to do so. When the leg is 
together and in working order, the knee movement is arrested by the 
striking of the vertical shaft of the T-joint against a pad placed in the 




No. 531. 



knee. This pad can be increased or diminished by the wearer, and the 
angular articulation of the knee made less or greater, as the wearer 
may desire. 

The center of motion of this knee is placed considerably back of the 
line of the center of gravity of the wearer. The purpose of this is to 
secure the knee against treacherous bending. 

The manner in which a leg for thigh stump should fit, depends 
largely upon the conditions of the stump. Generally speaking, the 
socket of the leg receives the stump quite tightly, and the posterior 
rim presses against the gluteal folds and the ischium. In some cases, 
especially with females, more or less pressure can be applied to the 
perineal regions. The end of the stump is not permitted to come in 
contact with any part of the fitting; it hangs practically in space. 
There are cases, however, when some pressure can prudently be 
applied to the extremity. Those cases are rare, but when they occur, 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



41 



advantage is taken of them and a suitable pad is placed in the socket on 
which the end of the stump obtains a seat. End-bearing" thigh stumps 
exist only when the ends of the femur are well covered with periosteal 
tissue. This condition is very seldom found, and never in amputations 
resulting from malignant diseases. 

Ancient and occasionally modern manufacturers permit most of the 
pressure to be applied to the perineal region. While we permit some 
pressure to be applied at that place, we limit the amount, as too much 
pressure at the perineum is frequently the cause of suffering, besides 
having a tendency to influence the wearer to " straddle " and swing his 
artificial leg outwardly. As there is really no necessity for all the 
pressure being applied about that region or on the extremity of the 






No. 532. 



No. 533. 



No. 534. 



stump, we do for cautionary purposes apply most of the weight about 
the ischial region, where it is absolutely safe and can do no damage, 
and cannot improperly influence the leg. 

Cut No. 532 represents a thigh stump, extending only a short dis- 
tance below the body, the stump smooth, but incapable of bearing 
pressure upon the extremity. 

Cut No. 533 represents a longer thigh stump with deep fissures and 
cicatrices across the extremity, also incapable of bearing pressure upon 
the end. 

Cut No. 534 represents a still longer thigh stump, with flattened ex- 
tremity, due to the integumentary folds and cicatrices, non end-bearing. 

Cut No. 535 represents a still longer thigh stump, which has a very 
thin covering upon the extremity of the femur. 



48 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



Cut No. 536 is also a thigh stump, with cicatricial complications on 
the extremity. 






No. 535. 



No. 536. 



No. 537. 





No. 538. No - 539 - 

No. 537, a similar stump, but a trifle longer. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



49 



No. 538, a long and large thigh stump with abundance of tissue on 
the extremity, capable of bearing pressure upon the extremity. 

No. 539, a thigh stump extending nearly to the knee, the extremity 
conical and tender. 





No. 540. 



No. 541. 



All of the above are types of stumps that are capable of wearing arti- 
ficial legs constructed upon the plan of No. 525. 



50 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



ARTIFICIAL LEGS FOR HIP-JOINT AMPUTATIONS. 

The amputation of a leg at the hip joint or very close to the hip joint 
requires an artificial leg similar in construction to the No. 525, hereto- 
fore described, with the exception that some modifications must be 
made in the means of adjustment and connection with the body. 

Cut No. 540 represents an amputation at the coxo-femoral articula- 
tion, after Furneaux-Jordan method, leaving a stump composed of tis- 





No. 542. 



No. 543. 



sue and no bone. A tissue stump of this kind is capable of performing 
limited functions in the management of an artificial leg ; a tissue stump 
is better than no stump at all. An artificial leg suitable for this stump 
is represented in Cut No. 541. 

The stump, in an amputation of this kind, presents a very peculiar 
appearance. It is large and more or less flabby, with many deep 
cicatricial fissures and folds of tissue. The end of the stump is capable 
of bearing pressure, thus relieving pressure at the perineum and 
ischium. 

Cut No. 541 shows the means by which an artificial leg can be 
firmly attached to the body. Cuts Nos. 542 and 543 show the leg 



A. A. MAEKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



51 



attached to the body, properly secured by means of a waistband, shoul- 
der straps, flexion and extension elastic straps, and the wearer ready to 
proceed in walking. 

A knee lock, which is combined with the mechanism of the knee, 
prevents the knee from bending* treacherously, and is found to be a 
desirable addition to limbs for hip-joint amputations. 

This knee-lock mechanism is illustrated and explained on p. 53. 




No. 544. 




In cases of hip disarticulations, where there are no stumps project- 
ing beyond the pelvis, it is found necessary to add a hip joint to the 
artificial leg". 

Cut No. 544 represents a hip-joint amputation, in which there is no 
protruding stump by which the artificial leg can be directed. 

Cut No. 545 represents an artificial leg suitable for the above case. 
There is in this leg a knee-lock at the knee, a hip joint extending above 
the thigh piece, a waist belt, and necessary shoulder straps. The waist 



52 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



belt assists in holding the leg in place by means of the elastic lacing 
band, which connects the front and back upper parts of the thigh 
piece to the belt. This method holds the leg firmly to the body when 
standing or walking. It is not deemed advisable to allow any hip 
motion while the wearer is walking. Hip motion is only admitted 
when stooping or sitting. An artificial leg for an amputation of this 





No. 546. 



No. 547. 



kind supports the amputated side in a very comfortable manner; the 
leg is thrown forward by means of a side motion to the body. The 
process of walking is attended with some difficulty at the start, but 
those adept in balancing, and possessing a fair amount of agility, soon 
learn to control a leg of this kind to advantage. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



53 



KNEE LOCK. 

The knee lock is a device which we place in the knees of artificial 
legs that require some artificial means additional to the excellent 
mechanism of the knee joint, in order to keep the knees from flexing, 
or from flexing beyond a fixed limit, when the wearer is standing or 
walking, but which is capable of being thrown out of action so that 
full flexion can be obtained for sitting purposes. It is not very often 
that knee locks are required; therefore, they are only occasionally 
placed in artificial limbs. 

Cut No. 546 represents an artificial leg with knee lock. A represents 
a sliding bar which can be pushed down or pulled up. When it is 
pushed down, the leg is incapable of moving at the knee, or is per- 




No. 548. 



mitted to move to a desirable point, when the knee-lock will check 
the knee action, as represented in Fig. 547. When the knee lock is 
pulled up, it is thrown out of action, and the knee is capable of bending 
to right angles, as represented in Cut 548. 

The knee lock is found of great value to equestrians, and is a great 
help to those who have short, weak, or deflected stumps. We have a. 
patron, a Baptist clergyman, who finds the knee-lock indispensable 
when performing the rites of immersion. On account of the buoyancy 
of the lower leg, the knee without the lock would flex and remain 
flexed the moment the clergyman attempted to walk while in the bap- 
tismal font. Knee locks are also found advantageous by persons who 
live in snow-bound countries. When the knee is locked and prevented 
from flexing, the wearer is better able to wade through snow drifts. 

The knee lock, hip joint, and waist belt can occasionally be combined 
to advantage, especially in legs applied to stumps that are unnaturally 



54 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



deflected, abnormally abducted or adducted, or that in any way hang 
out of the normal lines. The knee lock places the knee under control, 
and the hip joint holds the leg in line. As these additional parts com- 
plicate the construction of the leg, add weight, and more or less hamper 
graceful and natural walking, it is not considered desirable to have 
them present in an artificial leg unless the conditions of the stump or 
the occupation of the wearer demand them. 




No. 549. 



ARTIFICIAL LEGS FOR LONG THIGH STUMPS. 

It is desirable in all artificial legs that the axis of motion of the arti- 
ficial knee should be the same distance from the floor as the axis of 
motion of the natural knee. The mechanism in the knee of the No. 
525 leg, heretofore described, occupies three inches of the thigh above 
the knee, or, in other words, the axis of motion is three inches below 
the lowest point to which the fitting can be carried; therefore, long 
stumps cannot be accommodated by using the knee mechanism of the 
No. 525 leg, and in order to accommodate long stumps it is found neces- 
sary to employ the bolt joint described below. The bolt joint cannot 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 55 

be considered inferior to the T-joint, as the improvements which we 
have lately introduced make it equal in merits to the T-joint. 

Cut No. 549 represents an artificial leg calculated for long thigh 
stump. This leg is constructed of wood, covered with raw hide and 
enameled, terminated by a rubber foot, the same as the No. 525 leg, 
heretofore described. 

Cut No. 550 represents a back view of the leg. 





No. 551. 



No. 552. 



Cut No. 551 represents a section of the same leg with knee joint 
separated and all its detachable parts exposed to view. By the assist- 
ance of these cuts the reader can better understand the knee mechanism 
of this leg. A represents knee bolt, B represents the set screw; 
the bolt is inserted from the outside of the leg, passing through 
the knee, and is held in place by the set screw. C represents the 
check-rod which regulates the angle of flexion and extension. D 
represents the piston; E, spiral spring; F, cylinder; GG, check-rod- 
nuts; H, check-rod head screw; I, check-rod-head-screw-nut. 

The manner in which these parts operate, and the relations they boar 
to each other, are shown in Cuts 552 and 553. 



56 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



Cuts Nos. 552 and 553 represent section views of the No. 549 leg. 
The first cut represents the leg at extension ; the spring keeps the leg 
from flexing; the center of knee motion is back of the center of gravity 
of the wearer ; therefore, there is no tendency for the leg to flex when 
the wearer is directly over it. When the leg is flexed the action of the 
spring is reversed, and holds the leg at flexion, so that there is no danger 
of the leg flying out when the wearer is seated and unguarded. The 
action of the knee is exactly the same as that described under style 
No. 525 leg. 




No. 553. 



The knee bolt has a very long metal bearing; it passes through joints 
riveted to the leg, one on each side, and these hold the two parts of the 
leg together. The check rod has a long bearing at its head; the bolt 
which holds it in place has a safe connection by means of steel straps 
secured to the thigh section. These bearings are all neatly fitted; have 
composition journals; never rust or gum, and seldom require lubri- 
cants. We contend that this check-rod mechanism is superior to the 
ordinary knee-cord used in artificial legs of other construction, as the 
check rod is easily adjusted, can never stretch, and is absolutely 
reliable. It can be seen, by referring to Cuts Nos. 552 and 553, that the 
check rod passes through a bridge made of very strong wood; nuts and 
washers are placed on the end of the check rod, which impinge against 
the under side of the bridge, thus checking the action of the knee. The 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



57 



wearer of the leg can move these nuts and washers up or down, as he 
may wish, and obtain more or less knee motion and thus regulate the 
angle at which the foot will strike the ground when walking. 





No. 554. 



No. 555. 





No. 556. No. 557. 

Cut No. 554 represents a long thigh stump, the extremity insuffi- 
ciently protected to admit of end-bearing, 
Cut No. 555 represents a similar but longer stump. The extremity 



58 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

of the femur protrudes and is covered merely by cicatricial tissue, 
extremely sensitive, incapable of bearing pressure or enduring contact. 
Cut No. 556 represents a long thigh stump, well-protected extremity, 
capable of bearing pressure. Cut No. 557 represents a similar stump, 
well-protected extremity, end-bearing. It will be observed from the 
cut that the stump habitually inclines forward on account of contrac- 
tion of the flexors. This, although a slight inconvenience at the begin- 
ning, disappeared a short time after the stump was put into active use 
by the wearing of an artificial limb. 




No. 558. 

Occasionally long thigh stumps are well and evenly rounded, and 
are sufficiently protected on their extremities by periosteal and integu- 
mentary tissue to admit of pressure being applied to the extremities. 
Cuts No. 556 and 557 represent long thigh stumps capable of bearing 
pressure on ends. In cases of long, end-bearing stumps, and especially 
stumps that are flabby, a lacing front to the thigh-piece can be intro- 
duced to advantage, as represented in Figs. 558 and 559. 

Where thigh stumps are not so long as to prohibit the use of the 
T-joint, the No. 558 leg is applied ; and where the stumps are so long as 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



59 



to demand the use of the bolt joint, the No. 559 leg is applied. In 
either of these legs a large proportion of the weight is applied directly 
to the extremity of the stump, and the balance of the weight is taken 
about the perineum and ischium and along the sides of the stump. 
The laced stump admits of more or less contraction and expansion to 
produce comfortably tight bearings. The stumps represented by Figs. 
554 and 555 require the application of the No. 552 leg. Stump repre- 
sented by Fig. 556 can be accommodated by the No. 558 leg, and stump 
represented by Cut No. 557 can be accommodated by the No. 559 leg. 




No. 559. 



The question is frequently asked, why not make all sockets for thigh 
stumps wi',h lacing fronts, as represented in Cuts 558 and 559, as by 
doing so sockets are rendered more or less adjustable to changes that 
are likely to take place in stumps. In case a stump shrinks, the 
tightening of the socket will reduce the size of the thigh ; and in case a 
stump enlarges, the letting out of the lacing will allow the thigh to 
distend and accommodate the growth. In reply to this question we 
argue that in most thigh stumps, especially those that are firm, the 
necessity of rigid fronts to the sockets is more important than th 



60 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

feature of adjustability. It is as desirable in sockets for short and 
non-end-bearing stumps to have the fronts rigid as it is to have the 
backs rigid so as to properly support the superincumbent weight about 
the entire periphery of the socket. Sockets that are made entirely of 
wood are more durable than those that are made partly of wood and 
partly of leather. The leather absorbs perspiration, becomes soft and 
loses its rigidity, it becomes foul unless the wearer is very careful to 
keep his person clean ; the odor from the leather that has absorbed 
perspiration becomes very offensive. The softening of the leather, the 
folds and wrinkles that follow, destroy, in a large measure, the effi- 
ciency of an artificial leg when all the weight has to be applied to the 
top border of the socket. These objections are regarded as tenable, and 
justify us in adopting the wooden sockets in preference to the partly 
leather ones for all thigh stumps that are not end-bearing. 

The knee mechanism of the No. 558 leg is the same as that of the 
No. 525, and the knee mechanism of the No. 559 leg is the same as 
that of the No. 549. The material, construction, and finish are prac- 
tically the same as heretofore described. 



PRICES. 

Artificial legs for hip-joint amputations, with hip joint, waist belt, 
and suitable suspenders, each $100. 

Artificial legs for thigh stumps, with necessary suspenders and a full 
line of accessories, each $100. 

All measurements and diagrams required are fully called for on 
pages 178 to 182. 

As an evidence of the range of possibilities in meeting difficulties, we 
will introduce the following case : 

A deck hand on an ocean steamer was thrown from his feet when the 
vessel was struck by a tidal wave. He was thrown with such violence 
that his left arm and left leg were frightfully mangled. The arm 
was amputated at the shoulder joint, aiad the leg amputated a little 
above the knee. The hip joint of the left leg was dislocated, but 
yielded to treatment. A short time after the amputation the subject 
was taken with an epileptic fit and fell out of bed. The left hip was 
again dislocated, but was not noticed until two months after the occur- 
rence. It was then deemed unadvisable to attempt a reduction. The 
subject was confined to his bed for several months, when he was per- 
mitted to go about the hospital and grounds in a rolling chair. When 
his stump was healed we were called to take charge of him and do what 
we could for him. Upon examination we discovered that, on account 
of the dislocation in the left hip, the stump was thrown out of plumb. 
It inclined interiorly and anteriorly, and from disuse and long con- 
finement the right leg became involved, and the patient was unable to 
sustain his weight on that side. Our treatment of the case consisted in 
suspending him from a Meigs' Case apparatus, as represented in Fig. 
560. By this contrivance he was supported from his perineum and arm- 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



61 



pits, and could propel himself about by means of his remaining foot. 
After the use of the apparatus he regained considerable strength in his 
right leg, and an artificial leg was applied to the left side. In a brief 
time the right leg became strong, the stump hung in a vertical line, 




No. 560. 



and the patient was able to walk with his artificial leg in a very accept- 
able manner. He returned to his home in Europe, and reported, not a 
great while ago, that he was getting along very well and able to attend 
to business. 



62 



A. A MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



ARTIFICIAL LEGS FOR KNEE-JOINT AMPUTATIONS. 

Amputations that are made through the knee articulations provide 
stumps that require prothetical treatment peculiar to the conditions 
that exist in each stump. Stumps resulting from such amputations 
may be tapering and end-bearing, may be tapering and non-end-bear- 
ing, may be nodulous at the extremity and end-bearing, and may be 
nodulous at the extremity and non-end-bearing. 

A stump extending to the knee articulation that is tapering and end- 
bearing is one in which the condyles of the femur have been removed 
and the extremity of the stump protected with healthy tissue. The 
patella may be present or absent. 





No. 561. 



No. 562. 




"IWPtffiff 



No. 563. 



Cut No. 561 represents a thigh stump extending to the knee, the 
patella present. The stump is an end-bearing one, and may be 
regarded as exceptionally favorable. Artificial leg No. 549, page 54, 
represents the style of leg suitable for a stump of this character. 

Cut No. 562 represents a thigh stump extending to the knee, ex- 
tremity well protected, capable of bearing weight. As this stump is 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



63 



flabby and end-bearing, No. 559 leg, page 59, is especially suitable. The 
extremities of both of the above stumps rest upon comfortable pads 
placed in the bottoms of the thigh pieces. 





No. 566. 



No. 567. 



Thigh stumps that extend to the knees that are tapering and non- 
end-bearing are those that result from amputations in the knee artic- 
ulations with condyles removed, patellas either absent or displaced, 
the natural coverings to the bones at the extremities removed, and the 
ends of the stumps incapable of bearing weight. This condition is 
not always the result of imperfect surgery ; it .is more frequently due 



64 A. A. MAEKS, AETIFICIAL LIMBS, NEW YOEK CITY. 

to sloughing or some affection of the bone. The No. 549 leg, illustra- 
trated on page 54, is applied to such stumps. 

Cut No. 563 represents a thigh stump extending to the knee, the 
end incapable of bearing pressure, the condyles and all the natural 
coverings to the bone removed at the operation. Bunches of tissue 
or ganglia were gathered at the extremity and back of the stump, 
the integumentary tissues had puckered considerably, and the presence 
of cicatrices on and about the end all conspired to make it extremely 
sensitive, hopelessly incapable of ever enduring the slightest pres- 
sure or contact upon or about the extremity. Cut No. 549, page 
54, illustrates the style of leg suitable for that stump. 

A stump extending to the knee with a nodulous extremity, and 
capable of bearing weight on the extremity, is the most favorable of 
all the knee stumps. Stumps of this class result from amputations 
through the knee articulations, the condyles remaining untrimmed, 
the natural coverings to the bones permitted to remain on the artic- 
ulating surfaces, the patellas, if present, placed and firmly held in the 
intercondylic spaces, flaps well carried to the posterior, and the cica- 
trices some distance from the ends. Stumps possessing these favor- 
able conditions can be comfortably and efficiently accommodated with 
artificial legs constructed on the plan of No. 559, illustrated and 
described on page 59. 

Cut No. 564 represents the most fortunate type of stump extending 
to the knee articulation, the nodulous extremity due to the presence 
of the condyles, the perfect and natural coverings upon the extremity 
providing conditions that are desirable. No. 559 leg applied to case 
of above character fitted so that the entire weight of the wearer can be 
borne upon the end, the nodules providing means for holding the 
artificial leg in place without depending entirely on shoulder sus- 
pension, meets the requirements in the fullest degree. 

Cut No. 565 represents a side view of a similar stump. Style No. 
559 leg is especially suitable for this stump. 

A stump extending to the knee, with a nodulous extremity and inca- 
pable of bearing weight upon the extremity, although unfortunate, 
is capable of prothetical treatment. The causes for the inability to 
bear pressure on the extremity are not always bad surgery ; slough- 
ing, bone degeneration, hyperesthesia, etc., are frequently the causes 
of sensitive, irritable, and delicate extremities. 

Cut No. 566 represents a stump reaching to the knee, condyles 
present, but extremity covered with integumentary folds, deep fissures 
and cicatrices. Cut No. 567 represents a stump extending to the knee, 
condyles and patella present ; but bunches of soft and sensitive tissue, 
hanging from the extremity, prevent the weight being applied to the 
extremity, and prohibits any contact whatever. Stumps Nos. 566 and 
567 were fitted with artificial legs constructed on the plan of No. 568. 

Artificial legs for knee-joint amputations, such as Nos. 566 and 567, 
must be so constructed and fitted that weight will be applied at places of 
vantage, and the tender and irritable extremities thoroughly protected 
and not permitted to bear pressure. The ischial or perineal regions, 



A, A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



65 



and the sides of the stump are the only available places that will admit 
of close and firm contact. The sides of the extremities of sockets 
for these types of stumps must have ample recesses and cavities 
that will provide protection and prevent pressure on the nodules, 
condyles, or other bony processes. All pressure on the sides of such 



No. 568. 

stumps must be some distance above the extremities. In the No. 568 
leg, illustrated above, every condition is properly provided for. 
The top of the socket is annular and of proper size and shape to 
impinge against the gluteal and abdominal folds, and against the 
ischium. The socket narrows so as to press tightly against the sides of 
the stump, and is provided with ample cavities to accommodate the 
bony processes on the sides of the extremity of the stump. A part of 
the front is of leather, with eyelets and lacing; the stump is inserted 
from the top in this leg and held in place by means of a leather 
lacing front. The knee mechanism and the general construction of 
this leg are the same as illustrated in Fig. 551, page 55. Means of sus- 
pension are explained on pages 167 to 177. 

Price for artificial legs for knee-joint amputations, either style, Nos. 549, 
559, 568, with suitable suspenders and a full line of accessories, each $100. 

Measurements and diagrams required are called for on pages 178. 



66 A. A. MAEKS, ARTIFICIAL LIMBS, NEW YOEK CITY. 



ARTIFICIAL LEGS FOR BELOW-KNEE AMPUTATIONS. 

Amputations that have been made below the knees, or, in other 




No. 570. 



No. 571. 



words, through the tibias, leave stumps that are to be considered accord- 
ing to their classes, arranged in the following order : 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



67 



First. Those that are close to the knees, that are extended and 
anchylosed. 

Second, Those that are close to the knees, that are flexed when in 
use, or that are commonly called "knee-bearing" stumps. 

Third. Those that are long and mobile in the knee joints. 

Fourth: Those that are long and partially contracted in the knees, 
with limited knee motions. 

The first class is comprised of those stumps that extend to a point, a 
short distance below the knees, in which control of the stumps by the 
knee joints has become destroyed or impaired. The extremities of such 
stumps are seldom capable of bearing weight, and all the support must 
be applied to the thighs. 





No. 572. 



No. 573. 



Cut No. 569 presents a side view of a stiff knee, stump nearly 
straight. 

Cut No. 570 represents the case with suitable leg applied, patient 
sitting, and Cut No. 571 represents the same with patient standing. 
Style No. 574 leg was applied to this case. 

Cuts Nos. 572 and 573 represent views of similar stumps. An 
artificial leg, suitable for any one of these stumps, must be so con- 
structed as to provide knee articulation, and take all the support above 
the knee. 

Cuts Nos. 574 and 575 represent artificial legs suitable for such 
stumps. These legs will properly support the wearer without elongat- 
ing the thighs. They will admit of flexion and extension in the knees 
to accommodate sitting purposes and to produce a lifelike motion in 
walking. 

The thigh portion of one of these legs has the contours of the thigh of 



68 



A. A. MAEKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



the amputated side. No. 574 represents the leg with entire front pro- 
vided with leather, adjustable to a tapering .thigh, but in cases where 
the thigh is straight and weight has to be applied to the upper border of 
the socket, the socket must have an annular top, as represented in 
Cuts 575 and 576. The annular top makes the wearing of one of these 
legs very comfortable and pleasant by providing a continuous rim of 
wood to come in contact with the ischial, perineal, and inguinal 
regions, this is a desirable provision for taking weight for a stump of 
the character under consideration in which the sides are nearly parallel. 




No. 



No. 575. 



The stump is inserted in the front in No. 574 leg and at the top in 
the No. 575 leg. After the stump is in place, the leather form is drawn 
tightly by means of lacing; the leg is held securely without the 
necessity of heavy or tight shoulder strappings. The stump from the 
knee down, when tender, hangs pendent without taking any bearings. 



A. A. MAEKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



1\ 



Length of tibia insufficient to be of service in controlling the move- 
ments of a leg constructed on the plan of No. 589. 

When either of these conditions exists, the stump is necessarily a 
knee-bearing one. 

It frequently occurs that, from long periods of disuse and from 
habitually carrying the stump in a flexed position, the knee flexors 
become permanently contracted. In such cases, a knee-bearing artifi- 
cial leg should be applied.. It may, however, be safely asserted that 




No. 581. 



for all contractions of less than one-half the natural movement, and in 
which there are at least three inches of tibia left, artificial legs con- 
structed on the plan of No. 589, can be prudently applied. Legs of 
this kind bring gentle, constant, and painless tension on the flexors, 
and by degrees force them to relax, and thus ultimately obtain full 
knee movement. 

If the length of stump is a question of doubt in the selection of 
style of leg to be worn, the following suggestions may be of assist- 
ance: Flex the stump to right angles; if the stump projects two inches 



72 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



from the back of the thigh or popliteal space, it may be considered 
safe to select the socket leg, style No. 589, but if the projection is less 
than two inches, it may be considered that a knee-bearing leg is 
necessary. 

Cut No. 581 represents the side view of a knee-bearing leg. 

The socket and leg are composed of wood, covered with raw hide and 
enameled. The socket is excavated to fit the thigh and stump com- 
fortably; the leg portion is excavated to reduce weight, the foot is of 





No. 582. 



No. 583. 



rubber, as described in the fore-part of this book ; the mechanism of 
the leg is explained below. 

Cut 582 represents a side view of the knee, with parts connected, and 
583 presents the joint with all its parts separated. A represents the 
knee bolt, which connects the thigh and leg sections, and constitutes 
the axis of the knee ; this bolt works in metal bearings of considerable 
length ; one end of the bolt is flanged, and the other end squared ; the 
flange keeps the bolt from penetrating too far, and the squared end 
prevents the bolt from moving; B represents the screw that holds the 
bolt in place ; C represents the check-rod screw ; D, the check rod ; E, 
washer; F, check-rod nut; G, piston; H, spiral spring; I, cylinder. 
The relations and functions of these parts can be better understood by 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



73 



examining Fig. 584, which represents a sectional view of a knee-bearing 
leg. Cut 585 represents the same leg flexed to the neutral point, and 
Cut 586 represents the same leg at full extension. The action of the 




No. 584. 



No. 586. 



No. 585. 



spring holds the leg at flexion when wearer is sitting and urges the 
leg forward when the wearer is walking. The amount of articulation 
can be regulated by means of the set nuts, E and F, Fig. 588. 

It will be observed that in the knee-bearing leg the spring is placed 



74 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



forward of the check rod, whereas in the No. 549 leg the spring is placed 
to the rear of the check rod. This is merely a matter of convenience, to 
better accommodate a protruding stump; the action, however, is the 
same in either style. 

The knee mechanism of the knee-bearing leg is very durable, and 
will withstand severe service for years. 

The center of motion being placed below the natural knee, in style 
No. 581 leg, causes a disparity in the lengths of the two thighs; that is, 
the length of the thigh from the body to the end of the artificial knee, 




No. 587. 



when the artificial leg is in place, is from two and one-half to three 
inches greater than that of the natural thigh. The durability of the 
knee-joint mechanism in this style of leg fully compensates for the 
extra elongation of thigh; besides, the mechanism above described 
admits of the minimum width at the knee ; for, if the artificial knee 
articulations are placed on either side of the natural knee, in order to 
make the center of articulation of the artificial knee coincide with the 
center of articulation of the natural knee, there must be an addition 
of at least three-quarters of an inch on each side of the knee; this will 



A. A. MAEKS, AETIFICIAL LIMBS, NEW YOEK CITY. 



75 



produce a noticeably abnormal width at the knee which can only be 
concealed by wearing very wide trousers. The choice of style remains 
with the wearer; if he prefers the wide knee to the elongated thigh, 
and is willing to sacrifice the gain in durability, he can have the leg 
constructed with side joints, as represented in Figs. 587 and 588. 

The center of knee motion in an artificial leg constructed on the plan 
of No. 587 is brought to the sides of the knee by means of ginglymoid 
joints, the mechanism of which is represented in Fig. 590. The 
check rod is practically the same as that represented in Figs. Nos. 
583, 584, 585, 586, 587, and 588. This leg does not appreciably elongate 




No. 588. 



the thigh ; it admits of the distance from the center of motion of 'the 
artificial knee to the floor to be approximately the same as that of the 
natural knee; but, while there is a gain in this respect, there is a loss 
in durability. It is, however, a question for the wearer to decide, 
which of the two legs to select. If the selection is left to us, we invari- 
ably decide on the No. 581 style for all knee-bearing stumps. 

The third class of leg stumps comprises those stumps that extend 
from a point two inches below the knee to any point above the ankle, 
with knee joints that are mobile or but slightly contracted. 



76 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



Cut No. 589 represents the usual form of artificial leg for below-knee 
stump or tibial stump. 

Any stump that has a projection of two inches from the line of thigh 
when the stump is bent at right angles, and that has more than one- 
half knee movement, can be fitted with a leg of this type. 

This style of leg is constructed of a thigh part made from substantial 
leather; willow or basswood is used in the leg socket, the side joints 
are steel, and the foot is of rubber. The thigh piece is shaped to the 
contours of the thigh ; the leg socket is excavated to accommodate the 
stump properly and comfortably. The exterior of the leg is shaped to 




as near the natural form as the interior will admit of ; the socket is 
strongly banded, then covered with raw hide and enameled with a 
waterproof preparation that has a soft flesh tint. The wood from 
which the leg is carved is carefully selected, thoroughly kiln-dried, and 
the choicest that can be obtained. The thigh piece is made of oak 
tanned russet leather, lined with substantial buckskin. The knee 
joints are made of tough steel, and are of the ginglymoid plan ; the 
wearing surfaces are made very hard. Cut No. 590 represents a section 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



11 



of the knee, with the working parts separated ; aa represents screws 
that hold the bolts, bb, in place; cc represents bushings that work on 
the bolts and receive the wear; d represents check strap, which regulates 
the angular motion of the knee articulation. 

Price $100.00 each. 

The mechanical parts of the knee joint are fully illustrated in 
Cut 592. 

Side joints, sometimes called " hinge joints" or " ginglymoid joints," 
are used for legs in amputations below the knees, and occasionally for 
knee-bearing legs. These joints are more serviceable and durable when 
constructed so that one of the parts is admitted between two lips of the 
other part, the two parts connected by bolts and screws. The methods 




No. 590. 



employed by some makers of placing one part of the joint by the side 
of the other and bolting them together is unsatisfactory, as joints made 
that way wear irregularly sidewise, and admit of a wabbling motion 
after a short service. If the lateral strains on the upper sections could 
always be kept the same, this would not occur; but contracting the 
thigh of the artificial leg by lacing, in order to properly compress the 
reduced natural thigh, or by distending the artificial thigh in order to 
accommodate a natural thigh that has grown or enlarged, will force 
this irregular pressure, and unequal wear on the bearings will result. 
This cannot be avoided when the lap joint is used, but when one part 



78 



A. A. MAEKS, AKTIFICIAL LIMBS, NEW YOEK CITY. 



of the joint works within the slotted end of the other part, the entire 
upper section is held firmly to its bearings, and the wearing on the 
sides of the joints becomes minimized. 
The greatest wear in any joint is upon the bolt that holds the parts 




No. 591. 



No. 592. 



No. 593. 



together, and as the wear is the greatest when a person's weight is 
directly over the leg and becomes less as the leg is flexed, the bolt 
wears irregularly ; and as the wearing surface on the bolt has hereto- 
fore been limited to the thickness of the section that works upon the 
bolt, the wear has been very rapid. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 79 

The object of the present improvement is to increase the wearing 1 
surface as much as possible, and to have the wearing parts independent 
of the parts that resist strain, so that the wearing parts can be highly 
tempered and the parts that resist strain be left untempered, so that 
their supporting strength will not be impaired. 

In the improved joint, the wearing surface is increased over one hun- 
dred percent. It covers the entire surface of the bolt, and the interior 
surfaces of the holes in the lips of the lower joint. By referring to Cut 
No. 592 on opposite page, this mechanism will be clearly understood. 
AA represents the upper joint, BB represents the lower joint, C repre- 
sents a long bushing, which passes through the two lips of the lower 
joint and through the upper joint ; it becomes immovably fixecl. to the 
upper joint by means of the lug D. This lug holds the bushing by 
passing in the slot in the bushing. The bolt, B, passes through the 
long bushing and becomes immovably fixed to the lower joint by 
means of the stop pin, which is fastened to the Jiub of the lower joint 
and fits a recess made in the head of the bolt. The screw, A, holds 
the bolt in place and clamps the joint. 

A glance at the sectional Cut No. 593 will show how these parts 
work together. Every movement of the joint causes the long bushing 
to revolve about the entire surface of the bolt and in the lip's of the 
lower joint. This mechanism prevents any wear from taking place on 
either the upper or lower sections, and distributes the wear that takes 
place over the entire area of the bolt. The bushing and bolt are both 
made very hard, and can be removed and replaced with new ones at 
any time that the wearer may choose to do so. 

A pair of these joints has been subjected to a practical test, equiva- 
lent to that of being worn by a man weighing two hundred pounds, 
walking two miles every day for six consecutive years, without result- 
ing in the slightest perceptible wear or lost motion. The joints are 
made of the most suitable steel, forged from solid material, faced and 
slotted with absolute accuracy, drilled, reamed, and countersunk in 
templets, the parts fitted to a nicety, and thoroughly tested, every pair 
warranted. 

The thigh pieces are of durable leather, usually oak tanned russet ; 
they are formed to the shape of the thigh, and covered on the inside 
with buckskin. There are several methods by which the thigh pieces 
are made to compress the thigh; buckles and straps are sometimes 
used; metallic clamps are occasionally preferred, but the greatest num- 
ber of limb- wearers find a lacing method the most satisfactory, as that 
method admits of nicer adjustment, and is neat and durable. 

Cut No. 594 represents the older method of lacing; a row of eyelets 
is placed on each front edge of the thigh piece, and a strong buckskin 
lacing passes through the same. This method has been in vogue for 
many years, and is still preferred by many wearers to any other system. 

Cut No. 595 represents a system of lacing that has met with some 
favor; a row of hooks is placed on one edge of the thigh piece, and a 
row of eyelets on the other. When it is desired to remove the leg, the 
lacing is simply slipped off the hooks and allowed to remain in the eye- 



80 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



let holes. When the leg is put on, loops of the lacing are put over the 
hooks. 

Cut No. 596 represents the latest device for rapid application of a leg : 
a row of studs is placed on one edge of the thigh piece, and a row of 
eyelets on the other edge ; a separate piece of leather is provided with 
a row of eyelets on one edge, and a row of stud-holes on the other 
edge. This strip of leather is laced to one side of the thigh piece and 





No. 594. 



No. 595. 





No. 597. 



buttoned to the other side ; the lacing can be adjusted once for all. 
When it is desired to remove the leg, one side is simply unbuttoned 
or slipped off the studs, as represented in Cut No. 597. This device 
has been highly commended by many wearers. 

Cut No. 598 represents a short tibial stump, slightly deflected out- 
wardly, extremity poorly covered with tissue, &nee mobility normal. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



81 



Cut No. 599 represents a tibial stump, normal knee motion, great 
abundance of tissue on the extremity. 
No. 600 represents an amputation in the middle of the calf, knee 





No. 598. 



No. 599. 





No. GOO. 



No. 601. 



and hip joint contracted to the limit of extension represented in the 
cut, hip and knee both capable of flexion to the normal point. 

Cut 601 represents a stump extending to the calf, extremity very 
poorly covered; in fact, the tibia protrudes and is only covered by 
cicatricial tissue. 



82 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



Cut 602 represents si tibial stump, all conditions favorable. 
Cut 603 represents a tibial stump, extending to the lower third of 
the leg. 

Cuts 604 and 605 represent moderately long tibial stumps. 





No. 603. 




No. 605. 



Cuts 606 and 607 represent tibial stumps extending to the ankle or a 
short distance above the ankle joint. 

All the above cuts represent stumps that have been fitted with arti- 
ficial legs constructed upon the plan of No. 589. 



A. A. MAEKS, ARTIFICIAL LIMBS, NEW YOEK CITY. 83 



The stump, in each case, is inserted in the leg ; the thigh portion is 
laced about the thigh, it is laced sufficiently tight to hold the leg firmly 




No. 606. 




No. 607. 




No. 608. 



in place, the stump fits the wooden socket comfortably, bearings are 
admitted only about the enlarging part of the stump immediately 



84 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



below the knee; the anterior surface of the tibia is always accommo- 
dated by a channel ; the osseous process of the fibula is provided for by 
a cavity in the socket ; the end of the stump hangs in space and receives 
no pressure whatever, either on the sides or on the end, except when 
the conditions of the end of the stump will admit. 

In cases of extreme sensitiveness, the weight is carried entirely about 
the thigh, and the stump from the knee down is not permitted to bear 
any pressure. In this case, the stump performs no other function 
than that of directing the lower leg, moving it forward and bringing it 
backward. 

It is rarely the case that weight can be prudently applied to the 
extremity of a tibial stump ; the exceptions are only those stumps 




No. 609. 



that are protected by periosteal and integumentary tissue, and then 
only when the cicatrices are well away from the end. 

When these favorable conditions exist, we place an end-bearing pad 
in the socket of the leg. This pad is made to be adjustable so as to 
increase or diminish the amount of pressure on the extremity. 

Cut No. 608 represents No. 589 leg applied to a person when 
standing. 

Cut No. 609 represents the same case, but the wearer sitting. When 
the wearer is dressed, he is able to walk, run, sit, or lie down. Everj r 
posture will carry the semblance of nature, every movement will be 
made with surprising naturalness. The loss of the natural leg is abso- 
lutely concealed, and the substitution by the artificial leg restores the 
wearer to the amplitude of his usefulness. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



85 



Cut No. 610 represents an amputation below the knee of the left leg; 
the thigh of the same leg shortened three inches, on account of frac- 
ture of the femur and the lapping of the bone during the process of 
union. No. 589 leg was applied to this case. The artificial leg from 
the knee down was made three inches longer than the natural leg, in 
order to compensate for the shortening of the thigh. The leg proved 
very satisfactory, and enabled the wearer to walk and get about with 
facility, and without the need of canes or crutches. When seated, 





No. 610. 



No. 611. 



there was a perceptible disparity in the distances from the floor to the 
tops of each knee ; the right knee being three inches lower than the 
left — a condition that was unavoidable. 

Cut No. 611 represents an amputation of the right leg below the 
knee. The thigh of the opposite or left leg was fractured, and during 
the process of union became lapped, causing a shortening of , several 
inches on that side. An artificial leg constructed upon the plan of No. 
589 was applied to this case. The artificial leg was made several 
inches shorter from the knee to the bottom of the foot than the natural 
one. This was done to compensate for the shortening of the left 
thigh. This necessarily produced a disparity in the distances from the 
sole of each foot to the top of each knee — a disparity that was only 



86 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



noticeable when the wearer was seated. In other respects there were 
no inconveniences experienced in the management of the artificial leg. 

When ordering an artificial leg for a case in which there has 
occurred a shortening in either thigh, on account of fracture, arrested 
growth, or hip dislocation, be particular to call our attention to the 
amount of shortening, as well as its location and its general character. 

Sometimes there are conditions that make it impossible to obtain a neat 
and smooth adjustment about the knee and stump of the No. 589 leg. 
When the leg is made to adjust smoothly while it is held in extensiou, 
the knee and stump will pull away from the socket when flexed, caus- 
ing cramping and pinching of the tissues at the back of the stump in 
the popliteal region, and permitting the top of the socket to form a 
visible ridge in front, immediately below the knee. This is annoying, 





No. 612. 



No. 613. 



distasteful, and often the cause of suffering. The cause of this condi- 
tion can invariably be traced to some peculiarity in the anatomical 
arrangement of the knee, usually an abnormal curvature in one or 
both articulating surfaces of the knee. 

Cut No. 612 represents the bones of the natural knee joint when the 
knee is extended. 

Cut No. 613 represents the same flexed. 

It will be observed that, in passing from extension to flexion, the 
base of the femur has traveled over the entire bearing surface of the 
tibia; that the curvature of the articulating surface of the femur is not 
a regular curve ; it is neither elliptical, parabolic, nor volute. The bear- 
ing surface of the tibia is flattened or slightly curved. As these two sur- 
faces roll on each other, there is no point that can be located as the center 
of motion. The nearer the articulating surface of the tibia approaches 
a plane, and the nearer the articulating surface of the femur approaches 
an arc of a circle, the more uniform will be the motion of the knee ; but 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



87 



when the articulating surfaces of the knee of an amputated leg depart 
from these conditions, a modification in the mechanism of the artificial 
knee joint must be introduced in order to make the artificial leg articu- 
late harmoniously with the natural knee. The duplex knee joint has 
been invented by us to meet this condition. This joint admits of flexion 
and extension in polycentric curves. 

Cut No. 614 represents the conventional type of artificial leg for 
tibial stump applied to a stump with eccentric knee motion. The 
cut shows how the stump, when flexed, is pulled away from the front 
of the socket, and how the tissues are folded under the knee and 
pinched, due entirely to the effort of forcing an eccentric knee to act 
in unison with a unicentric joint. Cut 615 represents the No. 589 leg 





No. 614. 



No. 615. 



with duplex joints applied to a stump with eccentric knee. The result, 
as can be seen in the cut, is that the stump is held in the proper place, 
greater genuflection is obtained, the cramping at the back of the knee 
is obviated, and the stump is caused to remain close to the socket in 
front; the extremity of the tibia is pointed directly downward, instead 
of downward and forward, and is prevented from impinging against 
the interior anterior front of the socket. 

The duplex joint has two centers, one well up on the thigh and the 
other close to the knee; an independent strap connects the two side 
bars at the rear; an elastic band passes from one side bar over the front 
of the thigh to the opposite side bar. These straps give firmness to the 
adjustments, and at the same time admit of enough oscillation to bring 
about the desired result, no matter what may be the curvature of 
motion of the knee. 

This duplex joint is protected by letters patent bearing recent date. 



88 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



CONTRACTED STUMPS. 



The fourth class of leg stumps are those that are sufficiently long 
below the knee to control the movements of an artificial leg, but are par- 
tially contracted ; extension of the knee somewhat limited — so much so 
as to forbid the use of the ordinary type of No. 589 leg, and not suf- 
ficiently contracted to make it necessary to wear a knee-bearing leg. 

Cut 616 represents a partially contracted knee of a tibial stump. The 
stump is capable of full flexion, but extension is limited, as repre- 
sented. Cut 617 represents an artificial leg suitable for such con- 
traction. With this style of leg, the wearer is able to control the 
movements of the artificial knee by the stump, thus utilizing the motion 
of the knee to its limit. The artificial leg is fitted while the stump is 
inclined backward, the thigh is incased in the usual manner, and the 
stump is held to its bearings by means of a leather sheath, which is 
adjusted by lacing. When this leg is applied and dressed, there is no 
apparent irregularity, the lines of the leg are brought to as near the 





No. 616. 



No. 617. 



normal lines as possible, and the wearer is capable of walking and 
standing naturally. The stump rests on a pad, the thickness of which 
can be diminished, as improvement in the knee motion may admit. 

In almost every case of partially contracted stumps, the gentle, con- 
stant, and painless tension which is brought upon the tendons when 
standing and walking, results in breaking up the contraction and in 
bringing about full knee extension in an incredibly short time. As the 
tendons relax, the pads on which the stump rests can be diminished. 
When the contraction has entirely disappeared, a new socket can be 
placed on the leg, accommodating the stump after it has acquired full 
knee extension ; or, in other words, the No. 617 leg can be converted 
into the No. 589 type. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



89 



Cut 618 represents the leg for contracted stump applied, wearer walk- 
ing. Cut No. 619 represents the same case, with wearer seated. 





No. 619. 




No. 620. 



No. 621. 



Cut 620 represents a tibial stump, a little more contracted than the 
one previously considered. Cut 621 represents an artificial leg suitable 
for the case. A knee-bearing leg would at first glance be considered 
more suitable for this case; but as there is an angular movement 



90 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



of at least thirty degrees, and a possibility of improvement, it is 
advisable to subject the tendons to such strains as may force them 
to relax. The No. 621 leg is calculated to act upon the tendons 
in a painless manner, and to ultimately reduce the contraction. 
The shelf in the 62 L leg is so constructed that it can be placed in a va- 
riety of inclinations to accommodate greater extension when it occurs. 

Price for artificial leg for below-knee amputation, whether knee- 
bearing, contracted, or otherwise, with suspenders and a full line of 
accessories, $100 each. 

Measurements and diagrams required are called for on pages 183 to 188. 



ARTIFICIAL LEGS WITHOUT THIGH PARTS. 

Artificial legs for tibial stumps are sometimes made without knee- 
joints or thigh parts, depending entirely upon the sockets for support- 




ing the weight of the wearers, and on thigh and shoulder-straps for 
holding them in position. 

Cut No. 622 represents an artificial leg of this type. The socket is 
made to fit the stump perfectly, taking pressure at admissible places; a 
band of webbing or leather is buckled about the thigh immediately 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



91 



above the knee. A number of straps pass downward from the thigh 
band and are attached to the leg on the sides, on the back, and on the 
front. Two of the front straps connect with a shoulder-suspender, 
which supports the leg and assists in its management. 

Some manufacturers advocate the use of this type of leg for all long 
tibial stumps, and contend that the absence of knee joints and thigh 
parts is desirable, and that without them the muscles of the thigh have 
greater liberty and the stump is not as likely to become crowded under 
the knee. 

We admit that these reasons are plausible, and that it is an advan- 





No. 623. 



No. 624. 



tage to dispense with pressure about the thigh, and a boon to be rid of 
the metallic side joints. While we admit these advantages, we feel 
obliged to impress the fact that the absence of side joints and thigh 
support entails a great sacrifice of efficiency and subjects the stump to 
dangerous liabilities. Without thigh support a stump is forced to do 
all the work, it must withstand strains and contractile forces, and 
unless the stump is exceptionally strong and healthy, and abundantly 
protected by tissue flap, it will be constantly threatened with danger. 
Side joints are calculated to oppose side strains and the thigh part to 
carry a share of the weight, thereby relieving the stump. 

Cut 623 represents a thighless leg applied, the wearer standing, front 
view. Cut 624 represents the same, rear view. Cut 625 represents the 



92 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY 



same, side view, and Cut 626 represents the same with wearer seated. 
The object of these cuts is to show the operation of the leg, leather 
band, and shoulder strap when the wearer is standing, walking, or 
sitting. No matter what position he may be in, there are always some 
straps that are performing valuable work in holding the leg in place. 

When the wearer is standing with his weight on an artificial leg of 
the above type, the stump has to bear all his weight. This weight is 
permitted to come on the extremity of the stump only when the con- 



J 




No. 625. 



No. 626. 



ditions will admit ; otherwise it comes about the stump immediately 
below the knee. If the wearer makes a misstep and recovers himself 
by his artificial leg, the stump will receive a blow. If the wearer 
carries any heavy weight, his stump will be forced further into the 
socket, and suffering will follow. If the stump becomes smaller from 
emaciation, the troubles will be multiplied, pads and -wrappings will 
have to be adjusted with extreme nicety. These facts should be duly 
regarded before a thighless leg is selected. 

"We have known of many failures in attempts to wear artificial legs 
without thigh supports. The tearing of cicatrices, abrasions, excoria- 
tions, and general injuries to the stumps so frequently result that we 
feel impelled by a sense of duty to disparage and discountenance the 
use of artificial legs for tibial stumps that do not provide for taking 
some support above the knees. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



93 



Those who insist upon wearing thighless artificial legs, who have 
worn them from choice, and have had their stumps disciplined to their 
use, will be accommodated without further comment. 

Price of No. 622 leg, with necessary straps and suspenders and a full 
line of accessories, each $65. 

Measurements and diagrams required are called for on pages 183 to 1 88. 



NATURAL CROOK LEGS. 

All artificial legs described in preceding pages are constructed with, 
the leg portions securely attached to rubber feet at the ankles. This 
method has been in practice for many years, and is found to be satis- 
factory in the point of strength, neatness, and accommodation, with the 
exceptions as follows : 

First. Long stumps that extend to or near the ankles, and that are 
very large about their extremities. Such stumps forbid durable con- 




No. 627. 



nections of the feet with the sockets. The perspiration will in time 
destroy the waterproof coating placed on the insides of the legs, and 
saturate the wood and destroy the fastenings. 

Second. Wearers of artificial limbs who follow vocations that sub- 
ject their artificial limbs to continuous moisture— bridge-builders, 
oystermen, fishermen, woodsmen, raftsmen, trappers, and hunters. 
These persons must have artificial legs that are absolutely waterproof. 



94 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



The only way that we know of by which the two conditions above 
mentioned can be met, is by making the legs of wood with continuous 
and unbroken grains, running in the lines of the greatest strains. 
This is accomplished by carving each leg and core of foot from a 
natural-crooked piece of timber, and cementing the foot to the core, 
all of which is properly covered. Cut No. 627 represents a sectional 
view of a leg made in this manner. It will be seen that there are no 
mortisings required in this method, there are no pieces of wood con- 
nected by means of glue, cement, riveted bands, cords, joints, or other 
devices ; therefore, whatever may exude from the stump can do the leg 
no damage, and no matter how much or how long the wearer may 





No. 628. 



No. 629. 



stand in water or expose his leg to moisture, the leg can receive no 
further damage than that of marring the enamel or loosening the 
covering; the structural strength remaining unimpaired. This method - 
also admits of the minimum bulk of material surrounding the end of 
a long and large stump ; the diameters of the ankle of the artificial leg 
are but slightly larger than those of the end of the stump. 

Cut 628 represents a long tibial stump extending to the ankle, abnor- 
mally large about the extremity, and sensitive on the end. The 
natural-crook leg is obviously suitable for the case, as it will admit of 
fittings that will support the wearer, and provide ample room for the 
extremity of the stump without necessitating the obnoxiously large 
ankle so conspicuous in other methods. 

Cut 629 represents a long tibial stump extending to the ankle, ex- 
tremely sensitive about the end. The natural-crook leg is especially 
suitable for this stump, as the fitting can be carried well into the foot, 
making it impossible for the end of the stump to touch the bottom of 
the socket. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



95 



Cut 630 represents a natural-crook leg with thigh, shown in sec- 
tional view. The core of the foot and the body of the leg are approx- 
imately at right angles to each other. The lines in the cut represent 
the grains in the wood. They show that the grains curve with the core 
and body of the leg, so that there are no cross grains. The cut also 
shows that the socket can be excavated very deeply and made very 
large, so as to give ample room for long, large, and irritable stumps. 

It has always been an enigma with artificial-limb makers how to 
construct artificial legs suitable for long and large stumps, and those 





No. 630. 



No. 631. 



manufacturers who adhere to complicated ankle articulations find it 
impossible to produce substantial legs for such stumps, as the joints, 
springs, cords, and metal connections become corroded, stretched, 
broken, and generally disordered by the destructive exudations of the 
stump or the exposure to water. The natural-crook leg meets and 
overcomes all these difficulties, and, when finished, bears the regular 
appearance of the No. 589 leg. 

The prices for natural-crook legs are the same as those heretofore 
described. 

The natural-crook feature can be introduced into artificial legs to be 
worn on thigh stumps, knee-bearing stumps, or any other, and is 
desirable where the legs are to be exposed to water. The natural-crook 
feature is protected by United States patents. 

Price, $100 each when knee joints and thigh parts are applied, and 
$65 each when knee joints and thigh parts are not applied. 



96 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



ARTIFICIAL LEGS FOR ANKLE-JOINT AMPUTATIONS. 

The removal of the foot at the ankle articulation leaves a stump that 
is capable of excellent prothetic treatment. Such stumps are known 
among the surgical profession as tibio-tarsal or Syme's stumps, and if 
the os-calcis is retained and placed at the extremity of the stump, it is 
termed a Pirogoff's stump. These stumps are prothetically treated 
under two classes: First, those that can endure weight and pressure 





No. 632. 



No. 633. 



on the extremities, and, second, those that are sensitive on the ex- 
tremities and forbid the application of weight. 

The first class, or those that can bear pressure on the extremities, 
are usually those that possess the malleoli or ankle bones on the sides 
of the extremities, and that have nature's coverings on the ends of the 
bones. The presence of the malleoli is desirable, as they afford means 
for securing the artificial limbs without necessitating shoulder or 
thigh attachments. 

The flap on an end-bearing stump must be integumentary, firm, and 
healthy, with cicatrices well away from the ends. The stump should 
be capable of bearing some pressure on the palm of the hand, a test 
which the patient can apply himself. If the extremity of the stump is 
covered by cicatricial tissue, or if the end of the stump is too sensitive" 
to endure the pressure of the hand,. prudence will demand that an 
artificial leg be applied that places the weight at other points than on 
the extremity. 

Cut No. 632 represents an end-bearing stump, Syme's operation. 

Cut No. 633 represents an end-bearing stump, Pirogoff's operation. 
It will be seen that the cicatrices in either of these cases are away from 
the extremities, and all the puckerings of tissue are so disposed as not 
to interfere with pressure being applied to the ends. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



97 



Cut No. 634 represents a tibio-tarsal stump of an unrecognized char- 
acter. The extremity is covered with flap, and the wearer able to bear 
weight on the extremity ; there appears to be a displacement of flap 





No. 634. 



No. 635. 





No. 636. 



No. 637. 



and a lateral cicatrix that passes almost around the extremity. The 
malleoli have been removed, and the extremity permitted to become 
larger than the leg immediately above it. 
Cut No. 635 represents a model S} 7 !!^^ stump. 



98 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



Cut No. 636 represents a tibio-tarsal amputation. The os calcis, 
instead of becoming united to the tibial extremity, slipped during the 
healing period and was drawn backward and upward. The stump 
is an end-bearing one; the displacement of the os calcis does not pre- 
vent the application of the usual form of leg for a tibio-tarsal end- 
bearing stump. 

Cut No. 638 represents an artificial leg suitable for a tibio-tarsal 
stump of the types above referred to. 

. Cut No. 639 represents the leg applied. The socket of this leg is 
either carved from a natural-crook wooden block or cast out of 





No. 638. 



No. 639. 



aluminum, according as the conditions of the case demand. The foot 
is rubber, as described on page 24. 

The stump is placed in the socket from the front and is held* in place 
by means of a leather front, laced to fit tightly, as represented in Cut 
No. 639. When the socket is made of wood, it is covered and 
enameled. When made of aluminum, the metalis polished and the 
foot covered. The stump bears on an accommodating pad, which is 
calculated to receive most of the pressure. The socket is fitted to the 
sinuosities of the leg and stump, protecting tender places and applying 
pressure at places of vantage. 

If only part of the weight can be borne on the end of the stump, the 
upper extremity of the socket is made annular and sufficiently long to 
bear on the tapering part of the leg immediately below the knee. 

Cut No. 640 represents a leg of this character. It is obvious that the 
stump, being inserted from the top, will not enter further than the top 
of the socket will admit. The pad placed in the bottom of the socket 
is made in several parts, one placed on the other, and the amount of 
pressure applied to the end of the stump is regulated by the number of 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



99 



pads in use. Nos. 638 and 640 legs are objected to when applied to 
stumps that have very large extremities, as the requisite material on 





No. 640. 



No. 641. 



the sides of the sockets increases the diameters of the ankles so as to 
be objectionable. These legs are also subject to criticism, as they 




No. 642. 



offer no protection to sharp or sensitive shins. In order to obviate 
these objections, style No. 641 leg has been devised, and has become a 



100 



A. A. MAEKS, ARTIFICIAL LIMBS, NEW TOEK CITY. 



great favorite. This leg is constructed with socket of aluminum and 
foot of rubber. The foot is covered with suitable leather, and the 
socket is polished exteriorly and lined interiorly with sweat-proof 




No. 643. 



felt. The stump is placed in the socket from the rear, a leather sheath 
passes from the rear, encasing the stump and shell, and lacing over 
the aluminum front. The aluminum about the sides of the ankle is 
thin and does not objectionably increase the diameters of the ankle ; 
the socket protects the shin bone, and the end of the stump rests upon 
pads that can be increased or diminished in thickness to suit the 
requirements. 

Cut No. 642 represents leg No. 640 applied, and Cut No. 643 represents 
leg No. 641 applied. 

No. 641 leg has many advantages over No. 638. It provides a neat, 
unbroken front, dresses naturally, and possesses every requirement for 
easy, comfortable, and natural walking. The strain is carried from 
the front of the foot up to the front socket of the leg, and as the front 
line of the socket is about over the middle of the foot, the strain result- 
ing from rising on the ball of the foot is minimized. In the No. 638 
leg the strain is carried from the ball of the foot to the rear of the leg. 
As this distance is considerable, the material at the side of the ankle 
must be quite thick in order to possess the necessary strength. As 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



101 



these conditions are reversed in the No. 641 style, the amount of 
material necessary for structural strength is considerably less, and con- 




No. 644. 

sequently the No. 641 leg can be made much lighter and possess the 
same strength, 
A stump that is incapable of bearing the entire pressure on its 




No. 645. 



extremity can be provided with a leg, the upper portion of which is 
made annular, as represented in Cut No. 644. The annular top will 
support the weight immediately below the knee. The pads for the 



102 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



ends of the stump to rest on are composed of several layers, so as to 
admit of change to receive its proportion of weight. 

Cut No. 645 represents No. 644 ]eg applied. 

Cut No. 646 represents a tibio-tarsal stump and a leg suitable for the 
same. Cut No. 647 represents the same with leg applied, and Cut No. 
648 represents the same case with both legs properly dressed ; the loss 






No. 646. 



No. 647. 



No. 648. 



of foot is entirely concealed, and the wearer is restored to his ability to 
walk, run, or work. 

The second class of tibio-tarsal stumps are those that cannot bear 
pressure or weight on the extremities, due to imperfect healing, slough- 
ing, or other causes. Stumps of this class can always have artificial 
legs applied. The legs will prove helpful and advantageous, and can 
be so adapted as to protect the tender extremities from pressure, and 
to apply the bearings and take weight at places above and distant from 
the extremities. 

Cut No. 649 represents a characteristic non-end-bearing tibio-tarsal 
stump. The flap has been drawn to one side, and the cicatrix brought 
over the end of the stump, thus forbidding end contact. 

Cut No. 650 represents a tibio-tarsal stump in which a tender cicatrix 
passes laterally across the extremity. Cut No. 651 represents a stump 
in which the extremity is covered by cicatricial tissue only. Cut No. 
644 represents the style of leg that can generally be applied to ampu- 
tations of the above types. The annular top takes pressure immedi- 



A. A. MAKES, ARTIFICIAL LIMBS, NEW YORK CITY. 



103 



ately below the knee, and keeps the extremity from coming in con- 
tact with any surface. Occasionally additional assistance is necessary 






No. 649. No. 650. No. 651. 

to accommodate a stump that will not admit of pressure being applied 
immediately below the knee. When the occasion occurs, we corn- 




No. 652. 



No. 653. 



bine knee joints and thigh parts, as represented in Fig. No. 652. The 
lower section of this leg is constructed of wood or aluminum, as may 



104 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



be preferred. A rubber foot is attached to the extremity ; a leather 
sheath passes from the rear to the front, which holds the stump in 
place. Side knee joints, connecting the thigh parts with the lower leg, 
support the weight of the body. 
Cut No, 653 represents the leg flexed ; the thigh supporter distributes 





No. 654. 



No. 655. 



weight and pressure over a very large area, and in so doing not only 
relieves the stump, but renders the artificial limb more pleasant and 
tolerable. 

Side joints and thigh supporters may be considered absolutely neces- 
sary and indispensable when limbs are to be worn on irritable or sensi- 
tive stumps, or those that are poorly nourished or of impaired vitality; 
such stumps must have as little interference with the circulation as 
possible. The amputation of feet for frostbite, gangrene, or any 
malignant disease produces stumps that must be regarded as coming 
under this class, and should be treated in the manner above indicated. 

Cut No. 654 represents a double tibio-tarsal amputation ; extremities 
incapable of- bearing pressure, and the legs to the knees sensitive, for- 
bidding pressure or any interference with circulation. Cut No. 655 
represents a pair of suitable artificial legs applied. The nutrient ves- 
sels located in the stumps and about the knees rebel against any 
pressure. The treatment of this case in the manner indicated was 
highly successful, and the subject was brought to realize results that 
were far more gratifying than he had hoped for. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



105 



Cut No. 656 represents a stump extending to a point very close to 
the ankle, the extremity poorly protected and incapable of bearing 
pressure. The most unfortunate condition of this stump was the 
presence of a scale of uecrosed bone located on the anterior aspect of 
the tibia, about four inches below the knee. The scale was partly 
exposed, and surrounded by sensitive tissue. It was evident that no 
pressure could be applied to the end of the stump or about the diseased 
scale ; the bearing surfaces were limited to a very small area immedi- 
ately below the knee and above the diseased bone. An artificial leg 
that was especially adapted to the case was applied as represented in 
Cut No. 657. No pressure or rubbing was allowed about the diseased 





No. 656. 



No. 657. 



parts; all the weight was taken immediately below the knee and about 
the thigh. The case was successful in every respect. 

The importance of avoiding any pressure about the popliteal region, 
especially of long stumps, which require more nutrition than short 
ones, cannot be overestimated. If pressure is permitted to come on 
the vascular part of a long stump, strangulation will follow. This 
must be guarded against at air hazards, and extreme caution must be 
exercised to obviate such an unfortunate error. The necessity of apply- 
ing side joints and thigh supports to all artificial legs to be worn on 
long and doubtful stumps is apparent. 

An important feature, that should not be overlooked, is the fact that 
in artificial legs heretofore described there are no metallic connections, 
such as hinges, joints, or springs, nor any connecting parts, such as 
cords, bolts, or rods, to prevent the appropriation of ample room for 



106 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

the accommodation of the enlarged extremity of a long stump. The 
presence of the rubber foot, with spring heel and yielding toe, provides 
every requisite for easy, lifelike, and noiseless walking, without resort- 
ing to complicated connections, and without necessarily elevating the 
wearer two or three inches in order to obtain space for the accommo- 
dation of articulating parts. 



ARTIFICIAL LEGS FOR PARTIAL FEET AMPUTATIONS. 

Partial feet amputations are characterized by the surgical profession 
as tarso-metatarsal, or medio-tarsal, and are frequently designated by 
the names of the surgeons who first performed the operations ; as, for 
example, Chopart, Lisfranc, Heys, Hancock, and countless others. 

These amputations are performed for the purpose of removing dis- 
eased or crushed parts and sacrificing as little of the foot as possible, 
retaining the heel and a part of the foot for the purpose of enabling 
the subject to walk or stand on the remaining plantar surface without 
recourse to prothetical appliances. Although this may to all appear- 
ances be accomplished, it is not long before the subject discovers that 
his locomotion is greatly impeded by the absence of the front of a foot. 
He may pack the front of his shoe with cotton, cork, or other material, 
and may re-enforce the sole of his shoe by a steel plate, but he soon 
finds that these means provide but partial relief, and that the demand 
for some appliance that will enable him to rise on the ball of the foot 
and elevate his heel from the ground is imperative, and that there 
must be rigidity and great strength in the connection of the attached 
parts to his leg, especially if he is a laboring man. 

The construction of artificial feet for this class of amputations has 
perplexed artificial limb-makers for a great many years, and at the 
present time there are but few manufacturers who care to have any- 
thing to do with the supplying of artificial feet for partial feet amputa- 
tions. Some makers get up makeshifts which prove to be nothing 
more or less than artistic and neat forms of stuffed shoes that conceal 
the loss, but fail to supply the assistance that is needed. The absence 
of space between the end of the stump and the floor presented an 
insurmountable obstacle to the construction of a helpful and durable 
appliance until aluminum- was employed. 

Cut No. 658 represents a stump resulting from a partial foot amputa- 
tion. Cut No. 659 represents the manner in which the amputation is 
prothetically treated by most manufacturers. This foot is constructed 
of a leather shoe, which incloses the remaining portion of the foot and 
part of the ankle; a wood or rubber front of foot is placed in this shoe, 
a metal plate passing along the bottom of the foot from the heel to the 
toes. While this appliance restores a natural appearance to the ampu- 
tated member, it fails in supporting the wearer in a substantial man- 
ner. After a brief period the stump will crowd forward, causing 
unpleasant contact with the appliance; the foot, too, will bend at the 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



107 



end of the stump and fail to give the required phalangeal support, 
and, on account of the liberty this system gives, the heel of the ampu- 
tated foot will yield to the forces of the tendo- Achilles and become dis- 
placed. All these conditions are unfortunate and invariably bring 
disappointment. Cut No. 660 represents another ill-advised method 
of providing an appliance for a partially amputated foot. This appli' 
ance is constructed in the following manner: A sheet of metal is 
hammered to an accommodating shape to receive the remaining 





No. 659. 



No. 660. 



plantar surface of the foot ; it is bent up on either side to provide a 
joint to admit of ankle articulation; the upper parts of these 
joints extend up the sides of the leg, and are held in position by 
leather corset passing around the calf. The front portion of the metal 
sole is connected to a part of a foot ; this device is calculated to supply 
the deficiency, but sadly fails in its mission. The artificial leg is not 
held to the stump with that firmness that will admit of phalangeal 
support, and the insecure way in which the stump proper is held to 
the plate admits of more or less moving of the stump on the plate; 
this will produce chafing and will keep a tender stump in a con- 
stant state of irritation. Some manufacturers of the No. 660 plan 
attach a heel cord to the back of the metal sole, and run the heel cord 
up the back of the appliance, connecting the sole with the upper ends 
of the metal joints. It is not long, however, before the heel cord 
becomes stretched and inoperative; when newly put on, it fails to 
hold the foot firmly to the stump and arrest ankle articulation 
at the proper angle, to provide phalangeal support, or to prevent the 
amputated surface of the stump inclining downward and coming in 
contact with the metal sole or with the front part of the foot. A 



108 



A. A. MARKS, ARTIFICIAL LIMBS, MW YORK CITY. 



glance will show that either of the above mentioned legs (No. 659 or 
No. 660) must prove inadequate. When weight is applied to the ball 
of the foot, the heel of the artificial part will remain on the ground 
while the heel of the stump will lift away. The wearer will walk 
flat-footed and will frequently press the delicate amputated surface 
against the hard, resistant part of the attachment. These conditions 
will not only defeat the object of the artificial foot, but produce 
unpleasant results and much suffering. 

It may appear to some that a part of an artificial foot might be 
lashed to the remaining part of the natural foot sufficiently firm to 





No. 661. 



No. 662. 



enable the wearer to rise on the ball of the attached part. If this were 
possible, the method of treatment would be greatly simplified; but, 
unfortunately, compression of the natural heel benumbs the foot and 
cannot be tolerated. 

We desire to emphasize the fact that it is absolutely useless to apply 
any form of foot to a partial foot stump unless the artificial part is held 
sufficiently firm to enable the wearer to rise on the ball of the foot, 
and not only support his weight while in that position, but support 
such additional weight and resist such additional strains as his habits 
in life or occupation may require. 

The only successful scheme that we know of for meeting the de- 
mands for comfort, utility, efficiency, and durability consists in form- 
ing a shell of aluminum so that it will surround the front longitudinal 
half of the leg and remaining portion of the foot, thus providing 
a metatarsal body to which rubber toes can be attached. This shell is 
held firmly to the leg by means of a leather sheath, which holds the 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



109 



artificial part firmly to the natural, and distributes all the weight and 
strains over a large area of the leg below the knee. 

Cut No. 661 represents an artificial leg constructed on the plan above 
indicated. Cut No. 662 represents the same applied. The bearings in 
this limb are made comfortable by being properly fitted and lined with 
felt. The felt is attached to the aluminum by a sweat-proof cement. 
The bottom of the foot and the toes are of sponge rubber and provide 
a yielding, noiseless, and pleasant medium to walk and rise upon, at 
the same time producing results that closely imitate nature. 

The aluminum shell passing in front of the leg is especially desirable, 
as it protects the shin bone from any contact and applies the strain 





No. 663. 



No. 664. 



resulting from phalangeal resistance in the most direct manner. The 
leather sheath attached to the back of the leg is made to possess the 
shape of the calf of the natural leg. Where there is a tendency for 
the tendo Achillis to contract, the leather sheath is re-enforced with 
a metal form that holds the heel down in its proper place, thus coun- 
teracting the contracting tendency of the tendon. These artificial 
parts are so attached that they can be worn without inconvenience or 
suffering. The wearers walk naturally, striking the heel first, then 
rising on the ball of the foot; they are enabled to cany heavy burdens 
without endangering their stumps or producing painful contact. This 
method of treating partial feet stumps has the additional merit of not 
elongating the amputated side perceptibly. 

Cut No. 663 represents an anomalous partial foot amputation; the 
cicatrices are well away from the end and in front, the heel remaining 
and capable of bearing weight. 

Cut No. 664 represents a typical Chopart's amputation. 



110 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



Cut No. 665 represents a typical Lisfranc's amputation. 

Cut No. 666 represents a Hancock's amputation of part of foot. 





No. 665. No. 666. 

The cicatrix well away from the front ; the amputated surface well 
covered. 




No. 668. 



Cut No. 667 represents a Chopart's amputation, the remaining 
plantar surface unimpaired. 

Cut No. 668 represents the amputation of a front part of foot a little 
back of the toes. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



Ill 



Cut No. 669 represents a Chopart's amputation, with a slightly con- 
tracted tendo Achillis, a condition that is frequently met with in par- 





No. 669. 



No. 670. 



tial foot amputations, especially when the amputations are made 
above the insertion of the flexors. 
Cut No. 670 represents a similar case. Although these cases of con- 




No. 671. 

tracted tendons are unfortunate, they do not necessarily remove all 
hope of successful prothetic treatment. Style No. 661 leg can, as a 
general thing, be applied or so modified as to meet the conditions 
very successfully. 

Cut No. 671 represents an artificial leg applied to a partial foot 
amputation, the wearer seated. 



112 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



Cut No. 672 represents the leg applied and the wearer walking. 
Cuts Nos. 673, 674, and 675 represent partial feet amputations ; the 




No. 673. 




No. 672. 





No. 674. 



No. 675. 



contraction of the tendo Achillis has been so great as to draw the re- 
maining portions of the tarsus entirely out of their places. An 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 113 



artificial leg suitable for either of these cases must encase the rear 
longitudinal half of the leg and foot with aluminum, and have the 




No. 676. 



lacimrmrt in front. This method admits of closer fitting about the 
SS Z and bottom of the displaced heel, and holds that part 




No. 677. 
firmly in place, although it necessarily enlarges the diameters about 

th Cu°tNo. 676 represents a leg of this kind, and Cut No. 677 represents 
the same applied. We do not regard this style of leg desirable f roir 



114 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



an ornamental point of view, and only apply it when the conditions of 
the case demand. 

In partial foot amputations, where the remaining heel has been so 
greatly drawn out of place by the contraction of the tendo Achillis as 
to place the amputated surface directly on the extremity of the stump, 
the artificial parts must be so applied as to permit no pressure what- 
ever to come upon the extremities. An annular top applied to style 
No 661 or No. 676 leg will sometimes meet this condition, but occasion- 





No. 678. 



No. 679. 



ally the condition has to be met by means of side joints and thigh 
part, applying weight and pressure above the knee. 

Cut No. 678 represents the annular top applied to style No. 661 leg; 
This annular top is made of leather, formed to proper shape and made- 
very resistant. It can be opened at the back so as to admit the large 
end, after which the leather is laced firmly together and weight carried 
about the leg immediately below the knee. 

Cut No. 679 represents a leg, with knee joints and thigh support, for 
partial foot amputation, non-end-bearing stump. The lower section 
of this leg is made of aluminum, and encases the front longitudinal 
part of the leg. The rear is encased by a leather sheath which covers 
the aluminum shell. When in use the wearer stands on the artificial 
foot and his weight is applied to his thigh instead of about the leg or 
on the end of the stump. 

The use of aluminum in the construction of an artificial lee: for a 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 115 

partial foot amputation is especially advantageous, as the metal will 
admit of being worked to a shell of very slight thickness, thus adding 
imperceptibly to the diameters of the large stump it encases. The 
metal is strong and light, and is capable of being worked in any accom- 
modating form. The thickness of material under the extremity of a 
partial foot amputation need not be greater than one-eighth of an inch 
to possess the requisite strength. 

The utilization of aluminum in the construction of artificial legs 
must be limited to legs designed for long stumps with large extrem- 
ities, such as partial foot- and ankle-joint amputations, as the necessity 
for adding as little bulk of material about the extremities of such stumps 
is most important. When wood is used instead of aluminum, the case 
that surrounds the end of the large stump must be at least one-half 
an inch in thickness on each side of the stump. This adds one inch 
to the diameters of the stump, and makes the leg conspicuous and 
objectionable. 

During the past few years we have made many experiments, aiming 
at the general application of aluminum in the construction of artificial 
limbs, but we regret to say that thus far we have received but little 
encouragement. Aluminum socket legs for ordinary thigh or leg 
stumps are objectionable on account of their weight and their conduc- 
tivity of heat and cold. 

The characteristics of aluminum are its low specific gravity, its 
great comparative strength, and its non-corrosibility. Its weight is the 
least of all metals (one-quarter that of silver). Its strength is much 
greater than wood, and comparable with copper. It will not corrode 
when exposed to fresh water or to a moist atmosphere. We desire, 
however, to correct the impression that many persons have of this 
metal. We have often heard the remark that aluminum is lighter than 
cork and stronger than steel. These are the statements of ignorant 
persons, and are very wide of the facts. Aluminum will sink when put 
in water, cork and wood will float ; and although aluminum is strong, 
it has but a fractional part of the strength of steel. The utilization of 
aluminum is narrowed down to sockets for long and large stumps. 
We hold United States patents on artificial limbs of all descriptions 
with aluminum sockets, and if we could make good use of that metal 
for general purposes we would unhesitatingly do so. 



ARTIFICIAL TOES. 

The amputation of one or more toes from the foot interferes but 
slightly with standing and walking. If the healing has been com- 
plete, and the amputated surface well cushioned with integumentary 
tissue, a wad of cotton or any flexible form placed in the front of the 
shoe will answer every purpose, but if there are prominent bones, 
tender points, delicate spots, or irritable surfaces on or about the 



116 



A. A. MAEKS, AETIFICIAL LIMBS, NEW YORK CITY. 



extremity, a form of shield will be required that will protect those 
places and guard them against the encroachments of the shoe." 

Cut No. 680 represents a foot with the phalanges removed ; amputa- 
tion immediately back of the toes ; the amputated surfaces very delicate, 
demanding a protecting sheath. 

Cut No. 681 represents a sheath for the same, and Cut No. 682 
represents the sheath applied. This appliance is made of wood or 
aluminum, as may be more suitable. It is shaped to receive the foot 




No. 680. 




in a comfortable manner. Tender points in the region of the ampu- 
tated surface are provided with recesses that prevent contact. The 
appliance when strapped in place is covered with an ordinary shoe. 

Cut _No. 683 represents a foot with the great toe removed. The 
extremity very tender, demanding protection. 

Cut No. 684 represents an appliance suitable for the case. 

Cut No. 685 represents the same applied. The sole is so formed as to 




No. 683. 



No. 685. 



distribute pressure over the plantar surface of the foot, providing 
recesses for the tender spots, thus preventing those spots from touch- 
ing any part of the appliance, or of the shoe, no matter what position 
the wearer may be placed in, either walking, standing, or sitting. 

Appliances above described should not be used except when there 
are tender parts of the foot that require protection; they neither 
restore the needed parts nor improve the appearance; in most cases 
they increase the dimensions of the foot, and are sometimes objected 
to on that ground. 

Price for appliance, $30.00 to $50.00 each, according to conditions. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



117 



ARTIFICIAL LEGS FOR DOUBLE AMPUTATIONS. 

No matter how greatly a person may be dismembered, prothetic 
science is capable of rescuing him from a life of helplessness. A few 
years ago it was considered rash to apply a pair of artificial legs to a 
person who had lost both of his natural legs above the knees. Attempts 
to substitute such a large portion of the body depending on short thigh 
stumps for support resulted in failures, and until modern ideas were 
introduced and appropriate means for attachments were devised, 
failure followed every effort. According to records, in 1864 the first 





No. 686. 



No: 687. 



pair of artificial legs were applied to double thigh amputations, and 
those were applied by A. A. Marks to a subject of the Civil War. 
Although the subject was able to stand and walk on his artificial legs, 
the effort required to walk was so great that the wearer soon tired of 
them and abandoned their use, and became the occupant of a wheel 
chair, entirely dependent on his family during the rest of his life. 
In 1879 Mr. Marks made his second attempt, and succeeded admirably. 
The subject was a young man with two thigh stumps that reached 
nearly to the knees. This man soon acquired the art of balanc- 
ing, and got so that he could w T alk about the house without the 
aid of canes or crutches, but when in the street he found it necessary 
to use a pair of canes. He has operated on the same pair of legs 
that were made for him in 1879 up to the present time. He is engaged 
in active business pursuits, and has reared and supported a large 
family. 



118 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



Since 1879 the firm of A. A. Marks has applied over fifty pairs of 
artificial legs to double thigh amputations ; with knee locks, hip joints 




No. 688. 





No. 689. 




No. 690. 



No. 691. 



supporting bands, girts, and suspenders; the subjects have been 
enabled to manipulate their artificial legs successfully. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



119 



Cut No. 686 represents a case of double thigh amputations, front 
view. Cut No. 687 represents side view of the same case. It will be 
seen that both stumps are very short. Under earlier systems this case 
would have been considered hopeless, and the thought of artificial 
limbs would never have been entertained. 

Cut No. 688 represents the same case with a pair of artificial legs 
applied, front view. Cut No. 689, rear view. 

Cut No. 690, side view ; and Cut No. 691 represents the same case 
seated. These cuts show the knee locks, hip joints, suspenders, waist 





No. 692. 



No. 693. 



band, and roller straps. To these auxiliary attachments and to rubber 
feet can be ascribed the successful results that attended the case. On 
account of the limited lengths, of stumps it was deemed advisable to 
make the artificial legs as short as possible, without producing notice- 
able disproportions. 

Cut No. 692 represents a subject with both legs amputated midway 
between the body and knees. 

Cut No. 693 represents the case with artificial legs applied. This 
subject was a boy of nine years; he lost both of his legs by trolley cars. 
After a very brief time the child was walking about the house without 
the aid of canes or crutches. Although his gait was slightly awkward, 



120 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



his ability to get about without the assistance of an attendant was a 
source of great relief to his parents and comfort to himself. 






No. 696. No. 697. 

Out No. 694 represents double thigh amputation, the results of a 
railroad accident. Cut No. 695 represents suitable artificial legs 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



121 



applied, with knee locks, hip joints, and other helping attachments. 
The results attending this case are the most remarkable on record. 
Within two months after the artificial legs were applied this gentle- 
man was able to walk without the aid of canes or crutches. He bent 
his knees in a natural manner, could turn around when walking or 
standing, and sit down and rise from his chair without aid. 

Cuts Nos. 696 and 697 represent the same case standing, one with legs 
exposed and the other with legs dressed. 

Cut No. 698 represents double thigh stumps; amputations were 




U~^= 




No. 698. 



No. 699. 



made to remove deformed parts. Cut No. 699 represents the same 
case with artificial legs applied. On account of the great lengths 
of stumps, it was not deemed necessary to apply hip joints or waist 
bands. This subject is a musician and in a brief time after his arti- 
ficial legs were applied he was able to walk naturally and perform all 
the operations necessary to conceal his loss and appear gracefully 
in public. The artificial legs were constructed on the plan of No. 
587, and the methods of suspension were ordinary. This man has 
a national reputation as a clarionetist. He walks on the stage, plays 
the instrument, acknowledges encores, and retires in the usual stage 
manner. 



122 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

Cut No. 700 represents double knee disarticulations. A pair of No. 
549 legs were applied with suspending straps, attached to a vest which 
the subject wore under a white shirt. 




No, 700. 
Cut No. 701 represents the artificial legs applied, and Cut No. 702 
represents the subject dressed and walking. This man goes about with- 





No. 701. 

out the aid of canes or crutches; in walking he does not disclose his 
maimed condition to any perceptible degree. He attends to his busi- 
ness and earns a comfortable livelihood. The legs have automatic 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



123 



knee locks which admit of limited motion for graceful movements, the 
motion being arrested at a point that enables him to recover his equi- 
librium when necessary. For sitting convenience he can throw the 
knee locks out of action, thus admitting the legs to flex to the full 
limit. 

We have applied a great many pairs of artificial legs to double 
thigh amputations. We were the first manufacturers to have 
undertaken the task and to have met with successful results. We 
ascribe the success attending these cases largely to rubber feet, 





No. 703. 



No. 704. 



which, being attached permanently at the ankles, depending entirely 
on the elasticity of the rubber for accommodation (without springs, 
cords, or other mechanism), obtain a greater degree of safety and sup- 
port than it is possible by mechanical feet, which compel the balancing 
or walking on limited bases without phalangeal support. Rubber feet 
permanently attached have removed forever the despair with which 
these cases have been regarded . 

Cut No. 703 represents a double amputation, the right leg above knee 
and the left below knee. Cut No. 704 represents the same case with 
suitable artificial legs applied. Style No. 525 leg was applied to the 
right stump and style No. 589 to the left. These legs were sup- 
ported by means of straps connected with waist band and shoulder 
suspenders. 



124 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



Cut No. 705 represents a double amputation. Right stump five and 
one-half inches from the body, and left stump two and one-half inches 
below the knee. No. 525 leg was applied to the right side, and No. 589 




No. 705. 




No. 70( 



to the left. The subject was restored to not only a natural appearance, 
but the ability to walk without the aid of canes or crutches, and so 




No. 707. 

naturally that he has associated with persons for long periods without 
betraying the fact that his lower limbs were artificial. This young 
man has walked half a mile in eight minutes without great effort. 
He works at the bench during the day, and in the evening fre- 
quently spends hours at the billiard table. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 125 



Cut No. 706 represents him as he appears on his artificial legs, and 
in street attire. This man frequently rides horseback, rows a boat, 




No. 708. 

climbs a ladder, and indulges in those hazardous undertakings that 
require sound footing. 




No. 709. 



Cut No. 707 represents Mr. Kehr in a rowboat, showing the manner 
in which he can brace himself while pulling a strong oar. 

Cut No. 708 shows him at the pool table, and the manner in which 
he can balance himself on one foot while making a difficult shot. 

Cut No. 709 represents him on a ladder, a great distance from the 



126 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



ground; his footing is sound, his arms are free; he can hold a paint can 
in one hand while he applies a brush with the other. 




No. 710. 




No. 712. 




No. 711. 




No. 713. 



Cut No. 710 represents him riding horseback, securely seated in the 
saddle and feet in stirrups. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



127 



Cut No. 711 represents an amputation of both legs, the right nine 
inches from the body, and the left four inches below the knee. A No. 
525 leg was applied to the right side, and a No. 589 to the left. The 
results attending this case were as brilliant as those previously 
referred to. 

Cut No. 712 represents a case with both legs amputated. The right 
disjointed at the knee, and the left amputated three inches below the 
knee. Style No. 587 leg was applied to the right stump, and style No. 




No. 714. 

589 to the left. This man when in street attire presents the appear- 
ance of a person in possession of his natural extremities, as shown in 
cut No. 713. He walks naturally; never consents to use a cane. 
He is a member of the Knights of Pythias, and takes great pride in 
parading with his lodge. He walks great distances without experienc- 
ing unusual fatigue. Cut No. 714 represents him in his Pythian 
uniform. 

Double amputations, with the sacrifice of one or both knee joints, 
have been regarded as difficult for prothetical treatment, and only 
within the few past years have they been taken out of the category 
of doubtful cases. Those that are considered below offer no difficul- 
ties to the skilled prothetician. 

Cut No. 715 represents a double amputation ; the right three inches 



128 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



below the knee, and the left two inches below the knee; end of the 
tibia in the right stump protrudes, and is only covered by cicatricial 





No. 715. 



No. 716. 



tissue. The extremity of the fibula in the left stump is prominent and 
extremely sensitive. Notwithstanding these conditions, a pair of No. 





No. 717. 



No. 718. 



589 legs was applied and worn with comfort and efficiency, the sub- 
ject working on a farm and earning a comfortable livelihood. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



129 



Cut No. 716 represents a double amputation, each stump extending 
to a point a short distance below the knee. 




No. 719. 





No. 720. 



No. 721. 




No. 732. 

Cut No. 717 represents a similar case with longer stumps. 
Cut No. 718 represents a similar case, with deep folds of tissue at the 
extremities, and cicatrized spots on the front faces of the stumps. 



130 



A. A. MARKS, ARlijvIulAL LIMBS, NEW YORK CITY. 



Cut No. 719 represents a double amputation. Left stump a trifle 
longer than the right ; extremities tender, forbidding pressure. 

Cut No. 720 represents a double amputation, the right stump a 
trifle longer than the left; extremities tender, forbidding pressure. 

Cuts Nos. 721 and 722 represent double amputations. 

All the above cases were supplied with artificial legs constructed on 
the plan of No. 589. The wearers have all become expert in the use of 
their artificial limbs, capable of earning their own livelihood and 
supporting their families. 

Cut No. 723 represents a double leg amputation. The right stump 





No. 723. 



No. 724. 



six inches in length, and the left three inches in length. Suitable arti- 
ficial legs are shown in the same cut. 

Cut No. 724 represents artificial legs applied and exposed. This is 
the case of Mr. Frank Stewart, who had both of his legs crushed by 
railroad cars when a lad. He has worn artificial legs with rubber feet 
for many years, and has been an active man all his life; it is not 
unusual for Mr. Stewart to take long walks in company with 
his friends, who are possessed of nature's limbs, and who become 
fatigued as soon as he. When Mr. Stewart is at home he occasion- 
ally throws himself on the couch in an easy manner as shown in Cut 
No. 725. 

Cut No. 726 shows him in the act of ascending a ladder. His 
occupation requires him to ascend ladders and take weighty articles 
from the shelf. He can balance himself on the rungs, while his 



A. A. MAEKS, ARTIFICIAL LIMBS, NEW YOEK CITY. 



131 



hands are employed in lifting or carrying the articles he has to 
handle. 







No. 725.* 





No. 726. 



No. 727. 



Cut No. 727 represents Mr. Stewart in his street attire. Every evi- 
dence that his nether extremities are artificial is concealed. He is a 



132 



A. A. MAEKS, ARTIFICIAL LIMBS, NEW YOEK CITY. 



man among men, engaged in an active business pursuit, and for recre- 
ation joins his fellow-associates in an occasional outing, where fishing, 
hunting, boating, and other sports are indulged in. 

Although it may appear to be extraordinary for a man wearing two 
artificial legs to engage in labor of the most arduous kind, or indulge 
in sports of the most active character, it is an actual fact that men with 
artificial legs, who have healthy bodies, are just as prone to indulge in 




No. 728. 



invigorating sports as others. Sometimes they go beyond the limit of 
needful exercise, and vie with professional athletes. 

Thomas Cleary, who is represented in Cut No. 728, is one of this 
kind. He has made a number of public exhibitions of his marvelous 
pedestrian achievements. He has walked against time and competi- 
tors, and, although he wears two artificial legs, there are few with nat- 
ural legs who care to keep pace with him. He stands to-day without 
a challenger. The cut represents him as he appeared before an 
enthusiastic crowd a few years ago. 

Cut No. 729 represents Mr. James McDonald, who had both his legs 
crushed by a railroad train, and amputated below the knees. With a 
pair of No. 589 legs applied, he is equal to any task; he walks natur- 
ally, he rides a bicycle, as shown in Cut No. 730, in winter he often 
indulges in skating, as shown in Cut No. 731 ; he frequently attends 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 133 



parties, and always engages in the dance. He has been seen to leap 
over a fence four feet high, and never hesitates in joining his corn- 




No. 731. 

panions in everything they do that demands safe and sound footing 
and agile movements. 



134 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

Cut No. 732 represents Mr. William J. Harms, who had both of 
his legs crushed and amputated. With artificial -legs applied, he 
fills the position of baggage master and station agent at Parksville, 




No. 732. 



N. Y. His position requires him to shoulder heavy trunks, put them 
on trains, and haudle baggage of all descriptions. He acknowledges 




No. 733. 



that he has frequently carried on his shoulder trunks that weigh over 
one hundred and twenty-five pounds. 



A. A. MAEKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



135 



Cut No. 733 represents a switchman on one of the Western railroads 
who wears a pair of No. 589 artificial legs. He attends to the duties 
of his position with the same ability as one having" natural limbs. He 
has to move quickly, step over ties and rails, hasten from one track to 
another, and brace himself when moving a hard switch. His artificial 
legs serve him in these duties in the most reliable manner. 

Cut No. 734 represents a young man wearing two artificial legs for 




No. 734. 



amputations below the knees. He is a conductor on a Western express 
train, and is rendered capable of performing the services required of 
a conductor in the most efficient manner. He walks through the train 
when going at its greatest speed. He collects tickets and punches 
them with the suavity of one proud of his position; the car jolts, 
pitches, sways, and he retains his balance with no more effort or awk- 
wardness than if he were in possession of his natural legs. 

At stations he alights with agility, watches passengers, gives signals, 
and boards his train. It seldom occurs to him that his lower extrem- 
ities are not real, and he never betrays that fact to others. Day after 
day, for many years, he has performed this round of duties, and not 
a soul has had occasion to suspect his actual make-up, and only those 
to whom he voluntarily reveals his condition ever know of his de- 
pendence an artificial extremities. His movements are graceful, his 
appearance is natural, his step is firm and elastic, and his power is 
complete. With wooden articulating feet it would not be possible for 
his to discharge such duties. He would feel unsafe, tottlish, and 
unsteady, but with rubber feet, rigidly attached, he possesses sound 
footing and is capable of the most difficult feats of balancing. 



136 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



Cut No. 735 represents a double amputation, the right leg amputated 
at the ankle-joint and the left a few inches below the knee. The right 




No. 737. 



No. 738. 



leg was incapable of bearing pressure upon the extremity, and, there- 
fore it was deemed ad visible to apply an artificial leg constructed 
upon the plan of No. 652 to that side. The weight was carried about 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



137 



the thigh and immediately below the knee, and none whatever 
upon the extremity of the stump or upon the sides of the leg. A 
No. 589 leg was applied to the left side. Cut No. 736 represents the 
same case with appropriate legs applied. The results attending this 
case justified the adoption of the legs selected. The man has for 




No. 739. 



a number of years engaged in an occupation that required him to 
stand and walk a greater part of the time. 

Cut No. 737 represents a double amputation, the right leg amputated 
in the body of the foot, after Chopart's operation, and the left an inch 
and a half below the knee. The application of style No. 661 leg to the 
right side, and No. 589 leg to the left side, removed this man's dis- 
ability in a very complete manner. Cut No. 738 represents a double 
amputation— right leg below the knee and left at the instep, after 
Hancock's operation. A No. 589 leg was applied to the right side and 
No. 661 to left. 

Cut No. 739 represents a double amputation— the right leg ampu- 
tated below the knee and the left at the instep. No. 589 leg was 
applied to the right side and a No. 661 to the left. This man was 
restored to his ability to engage in his former occupation of oyster- 
man. The cut represents Mr. Mills in a boat, raking for oysters on 
Long Island Sound. He says that he has devoted fifteen years to 
the oyster business, doing the work himself. During that time lie 
has raked as many oysters, worked as many hours, and has actually 
done as much work as most of his fellow-oystermen who were in 
possession of their natural limbs. 



138 



A. A. MAEKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



Gut No. 740 represents a double amputation — right leg amputated 
through the knee-joint and the left at the ankle. In this case 
pressure could be carried on the extremities of both stumps. No. 559 
leg was applied to the right side and a No. 638 leg to the left side. 

Cut No. 741 represents Mr. Sterner with artificial legs applied, and 
Cut No. 742 represents him attired as he appears in daily life. He 
walks naturally, and attends to a laborious occupation without diffi- 
culty or hindrance. 





No. 740. 



No. 741. 



Cut No. 743 represents a right leg amputated a little above the 
ankle, and the left leg at the instep. A No. 589 leg was applied to the 
right side and a No. 661 leg to the left side. 

Cut No. 744 represents a double amputation — right and left feet 
removed at the insteps. A pair of No. 661 legs were applied to this 
case, and the wearer was so completely restored that he found himself 
able to walk great distances without fatigue. 

We feel that the cases above quoted are ample to establish the fact 
that no matter how greatly a man may become dismembered in his 
lower extremities, it is possible for him to become possessed of substi- 
tutes that are comfortable to wear, natural in their action, and advan- 
tageous. We have endeavored to show stumps of every character, 
length, and peculiarity, and combinations that will apply to every pos- 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



139 



sible case. These are no empty boastings, exaggerations, or misrepre- 
sentations. Every one can be verified, and any incredulous person 




No. 742, 





No. 743. 

can have his doubts removed by writing or calling on any of the parties 
referred to; their names and addresses will be given upon request. 



140 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



APPLIANCES, BRACES, AND EXTENSIONS FOR SHORT- 
ENED LIMBS.— APPARATUS FOR RESECTIONS, DE- 
FORMITIES, AND DEFICIENCIES. 

Many lower limb disabilities should be treated the same as amputa- 
tions, as they demand either artificial legs, or parts of artificial legs, to 
make up deficiencies or to support the weakened parts. 

It can safely be assumed that no matter what deficiency there may 
be in one or both of the lower extremities, that deficiency can be cor- 
rected to a helpful degree. No matter what weakness there may be in 
one or both legs, those weakened parts can be supported by mechan- 
ical devices. No matter how crooked, distorted, or deformed one or 
both legs may be, there is still hope of some appliance l)eing attached 
that will improve locomotion, and that will hide the deformed parts 
from view. We will consider a few of the cases that have come under 
our treatment. 





No. 745. 



No. 746. 



Cut No. 745 represents a case of arrested development. The child 
was healthily and normally constituted from the hips up, but from the 
hips down both legs were diminutive, ill-formed, and distorted. The 
child was capable of bearing his weight on the bottoms of his rudi- 
mentary feet, and by a wobbling motion and by the aid of crutches, 
he was able to get about in a very unnatural, fatiguing, and piti- 



A. A. MAKES, ARTIFICIAL LIMBS, NEW YORK CITY. 



141 



ful manner. The case was brought to us. Upon examination we 
found that we could force the legs into nearly correct lines without 
producing pain. A pair of artificial legs were applied that held the 
crooked limbs in their proper lines and elevated the child to his 
proper height. Rubber feet were attached to the extremities of the 
limbs. Weight was applied to the bottoms of the ill-formed feet, 
and in a very brief time the child was able to walk without crutches. 
He controlled the artificial knee joints by means of his feet, and found 
little or no difficulty in balancing, walking, sitting, rising, ascending 



J& 



/(Mil 


^\ vt N 




=cj3__ 




\ '&A 








-~^ 



No. 747. 

or descending steps. The articulations at the knees were on lines of 
progress, and the artificial legs corrected in a measure the rotated and 
abducted hip-joints and adducted knee-joints. Considerable attention 
was given to ornamentation, and the child, when dressed, had his 
deformities entirely concealed. Cut No. 746 represents the lad with 
legs applied and dressed. 

Cut No. 747 represents a congenital deformity. The man was well 
formed from the hips up; on the inner sides of both thighs were bony 
protuberances; the legs seemed to have grown from the sides of the 
thighs, and the feet were inverted and ill-shaped. This person, during 
his adolescence, found locomotion only possible by hitching himself 
about on his haunches, or on his knees, dragging the deformed legs 
after him. The rolling chair was his only alternative. For twenty- 
five years he submitted to his unfortunate condition, paying no atten- 
tion to suggestions that were made for his relief. When twenty-live 
years of age, his pride moved him to have something done that might 



142 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



ameliorate his condition. Dr. Montague Boyd of Charleston, S. C, 
was consulted, and, after conferring with us, the removal of the bony- 
protuberances from the right thigh and both legs at their junctures 
with the thighs was decided upon. The operation was skillfully and 
successfully performed, and the man was provided with two excellent 
thigh stumps, as represented in Cut No. 748. We applied a pair of 
artificial legs to him, as represented in Cut No. 749. This case is 
referred to more at length on page 121. 
Cut No. 750 represents the lower extremities of a case of obstructed 





No. 748. 



No. 749. 



growth ; the left leg rudimentary and greatly deformed, the hip joint 
normal, the thigh possessing nearly the proper length terminating in 
a very short and deformed leg. A number of places on the extremity 
of the thigh and the tibial aspect of the leg afforded surfaces for 
pressure. 

Cut No. 751 represents a leg devised for the case. When applied 
and both limbs dressed, the deformity was concealed, and both legs 
presented similar appearances. This man was able to walk nearly 
as well as if his left extremity were natural. A slight enlargement 
of the trousers a little above the knee (necessary to accommodate 
the deformed leg) was the only noticeable difference in the two 
sides,' and that difference was so slight that attention was seldom 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



143 



attracted to it. The main object in this case was achieved — that of 
enabling the man to walk without canes or crutches. 




</) 



< 



No. 751. 




No. 752. 



No. 753. 

Cut No. 752 represents an ununited fracture of the right tibia, due 
to gunshot wound received in the Civil War. The injury was 



144 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



confined to the tibia. On account of tibial weakness the fibula was 
overtaxed, and a support became necessary. An indentation deep 
enough to hide a finger had always been present in the leg at the 
point of injury, two inches below the knee. 

Cut No. 753 represents the brace that was applied. It relieved the 
fibula, by carrying the weight of the wearer about its top. The injury 
caused a shortening of an inch and one-half in the entire length of the 
leg; a half sole was attached to the extremity of the brace to com- 
pensate for the shortening. 

Cut No. 754 represents a deformity of the right leg; the hip, thigh, 
and knee normal and healthy, but the leg and foot arrested in their 





No. 754. 



No. 755. 



growth remained diminutive, capable, however, of taking weight at 
the bottom of the foot. 

Cut No. 755 represents an artificial limb especially devised for the 
case'. The undeveloped leg was received into the socket, the foot pro- 
truded through an aperture on the external side, knee joints and 
thigh piece were placed above the knee, receiving support and strength 
about the thigh. A rubber foot at the lower extremity completed the 
structure and provided a support adapted to the case. 

Cut No. 756 represents a deformity of the right leg ; hip joint normal, 
thigh abnormally short, knee joint weak, leg and foot short and 
atrophied. 

Cut No. 757 represents an artificial leg designed for the same. The 
leg supported the weakened member and added sufficiently to com- 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



145 



pensate for deficiency in length. The socket encased the leg and foot, 
the joints strengthened the knee, and the thigh part encased the thigh. 
The deformed foot was dropped to the limit of toleration, so as to be 




No. 756. 




No. 758. 




better concealed by the trousers. This appliance proved to be efficient 
and satisfactory. 

Cut No. 758 represents a deformed left leg. From knee down the 
leg was misshapen, contracted, and distorted. Cut No. 759 represents 
a suitable artificial leg applied. The deformed parts well up and out 
of the way. 



146 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



Cut No. 760 represents a deformed lower right leg, quite similar to 
the one previously described; the knee, however, admitted of more 





No. 760. 



No. 761. 



flexion, and the artificial leg was made to receive the thigh and de- 
formed part in one socket, held in place by means of a leather sheath 





No. 762. 



No. 763. 



passing from the rear and lacing on the front line of thigh, as repre- 
sented in Cut No. 761. 
Cut No. 762 represents a deformity of the right leg. The hip and 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



147 



thigh were normal, the bones of the leg rudimentary or absent. A 
foot rather undersized appeared to have grown from the knee down- 
ward. The patient was able to flex and extend the foot the same 
as a leg, or, in other words, he had an articulation at the junction of 
the thigh and the foot. Cut No. 763 represents an artificial leg devised 
for the case. The leg is similar, in its general construction, to that 
represented in Cut No. 589. The socket of the leg was excavated to 
receive the foot, the knee joints and thigh support encased the thigh 
and gave the foot control over the artificial part. The results proved 




No. 764. 



No. 765. 



that the amputation of the foot at the junction with the knee would 
have been an unwarranted sacrifice. 

There are three- important features to be regarded in constructing 
and applying braces and extensions for shortened legs. First : Supply- 
ing the deficiencies in length ; second, providing fittings that are com- 
fortable, and third, concealment of the deformities. It is frequently 
difficult to harmonize the second and third conditions, and occasion- 
ally the cause for many experiments. The foot must be inclined in 
order to admit of being concealed by the trousers, and the degree at 
which the foot can be inclined governs the extent to which the con- 
cealment can be carried. It is not always possible for the subject to 
determine the "greatest angle of endurance " of the foot, and as this is 
an important matter, it should be considered necessary for the subject 
to confer with us personally, and permit us to determine that point. 
This is more important with a gentleman than with a lady, as the lady 



148 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



can conceal the appliance by her skirts more readily than a man can 
by his trousers. 

Cut No. 764 represents an undeveloped left leg, the entire limb 
considerably atrophied and the joints weak, caused by infantile 
paralysis. 

Cut No. 765 represents an artificial leg expressly designed for the 
same. The deformed leg is received in the socket and laced in place, 
the foot dropped to the angle of toleration. The thigh piece encases the 
thigh and the knee-joints support the knee. A rubber foot is placed at 
the extremity of the artificial member which completes the structure 




No. 766. 



No. 767. 



No. 768. 



and provides a means that enables the wearer to walk without the aid 
of canes or crutches and without any perceptible limp. 

Shortened and paralyzed legs are frequently accompanied with total 
loss of the power of extension and flexion in the knee joints. In such 
cases, the mechanism of the artificial knee joints are provided with 
locks that hold the knees rigid when standing or walking. The joints 
are capable of being unlocked to admit of flexion when sitting. 

Cut No. 766 represents a shortened, weakened, and atrophied leg, the 
results of hip joint disease in youth. Cuts Nos. 767 and 768 represent 
the same case, with brace and extension applied. The structure con- 
sists of a socket that encases the leg, knee joints that support the knee, 
thigh piece that takes support about the thigh, and a rubber foot that is 
placed under the deformed natural foot in order to obtain the proper 
height. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



149 



Cut No. 769 represents a right leg deformed from the knee down. 
The deformity consisted of a malformed foot, a deficiency in length, 
and abnormal relations of the tibia and fibula. The tibia extending to 
the ankle, without connecting with the foot ; the fibula connected 
with the foot, but "not with the knee. The two bones appeared to be 
held by cartilage only. When the subject placed his weight on his 
right foot, he would sink over an inch; no pain followed, but the leg 
lacking structural support rendered the subject incapable of walking 
but short distances. Cut No. 770 represents the appliance devised 
for the needs of the case. It consisted of an aluminum shell, ham- 





No. 769. 



No. 770. 



No. 771. 



No. 772. 



mered to proper shape, and made to comfortably encase the leg and 
foot from the knee down, extending upward to the slope of the knee, 
where weight was received. Every time the wearer applied his weight 
to the right side, he supported himself immediately below the knee. 
The aluminum shell held the fibula and tibia in juxtaposition. 
A rubber foot was placed under the shell so as to obtain proper length 
and obviate the jar when walking. The wearer has had the above 
appliance in use for many years, and has found it to be valuable 
beyond estimate. He can walk great distances without fatigue, and 
can attend to his vocation with nearly the same ability as if his 
right leg were normally constituted. 

Cut No. 771 represents a shortened and imperfectly formed leg, 
which from the knee down was atrophied, and shortened by four 
inches when compared with the opposite leg ; knee normal and weight 
capable of being carried on the bottom of the foot. 

Cut No. 772 represents a suitable leg for the same. This leg was 



150 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



constructed to receive the deficient member, and give proper support to 
it. A rubber foot, placed under the foot-rest, produced the required 
length. In this case, it was not possible to drop the toe to a conceal- 
able angle, therefore, the appliance presented the appearance of a 
double foot, but, as the natural foot was somewhat smaller than the 
artificial, it became possible to conceal the encased foot by trousers 
with broad bottoms. 
Cut No. 773 represents an ununited fracture in the right leg imme- 






No. 773. 



No. 774. 



No. 775. 



diately above the ankle. Usually, in cases of this kind, it is deemed 
advisable to remote the leg by amputation, but in this case the patient 
would not submit, and as several attempts to force union had failed, 
further attempts in that direction were abandoned, hoping that, as 
the subject was young, nature, through her mysterious ways, might 
unite the two parts ; therefore it was deemed advisable to apply a 
brace that would take the weight entirely away from the bottom of 
the foot and transfer it to the leg below the knee. 

Cut No. 774 represents the appliance constructed for the case. It 
consisted of an aluminum shell which encased the leg in a manner 
that held the parts in proper positions, and at the same time carried the 
weight from the knee to the floor. The child has worn this shell for 
some time, and has been able to be about and take active and healthful 
exercise. 

Cut No. 775 represents a deformed leg and foot. The foot on the right 
leg had the appearance of having grown from the external side of the 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



151 



tibia, the fibula imbedded in the tarsus. Weight could be carried on 
the bottom of the foot, and on the extremity of the tibia. 





No. 776. 



No. 777. 



Cut No. 776 represents a leg designed for the case. 

Cut No. 777 represents the side views of deformed and artificial legs'. 






No. 778. 



No. 779. 



No. 780. 



The socket of the artificial leg was fitted to all the sinuosities of the 
deformed leg and foot, and supported those parts so that weight would 



152 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



have a general distribution over parts of vantage. The wearer was 
capable of walking with this appliance without the aid of a cane. He 
suffered no hindrance or discomfort, and had his deformity very effect- 
ually concealed. 

Cut No. 778 represents a left leg, anchylosed at the knee. This condi- 
tion was brought about by a gunshot wound received in the War of the 
Rebellion. The knee became bent to nearly right angles and stiff. 
The angle at which the leg became fixed caused a vertical shortening 





No. 781. 



No. 782. 



of about four inches. Hip motion normal, \high and leg well devel- 
oped, foot healthy and capable of bearing pressure on its sole. 

Cut No. 779 represents an extension designed for the same. 

Cut No. 780 represents the extension applied. As will be seen, 
the leg was received from the rear, and held in place by lacing. The 
axis of the body was carried down the affected leg a little back of the 
center of the knee and through the arch of the foot. This direction 
of force was accommodating to the conditions, and enabled the 
wearer to walk with little exertion and with great comfort. 

Cut No. 781 represents a shortened left leg caused by hip joint dis- 
ease in youth. The shortening (located entirely at the hip) produced 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



153 



a deficiency in length of about six inches ; knee strong, bottom of 
foot capable of bearing weight. > 

Cut No. 782 represents a suitable leg designed for this case, the nat- 
ural foot was dropped at a slight angle and made to rest on a shelf 
placed some distance above a rubber foot ; the leg was encased by a 
socket made of wood and leather. As the shelf on which the natural 
foot rested was some distance from the floor, and as the subject was a 
female, the appliance was readily concealed by skirts ; therefore, the 





No. 783. 



No. 784. 



dropping of the foot to an extreme angle, merely for concealment, 
was not considered necessary. 

In all cases of shortened legs, where the shortening is over three 
inches, we deem it necessary to have the extension brace run well up 
on the leg to very near the knee, in order to properly relieve the ankle 
of the strain that would otherwise come upon it. This straiu increases 
as the distance between the ankle-joint and the floor becomes greater. 

Cut No. 783 represents a shortened leg, right side, the deficiency 
amounting to about six inches. The angle at which the foot could be 
dropped, being considerable, the leg represented in figure 784 not only 
supplied the deficiency in length and supported the ankle and sides of 
the log, but effectually concealed the disfigurement. 



154 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

Cut No. 785 represents the support applied, and Cut No. 786 repre- 
sents the manner in which the deficiency was concealed by the trousers. 





No. 785. 



No. 786. 




No. 787. 




No. 788. 



Cut No. 787 represents a leg shortened by hip disease, the shortening 
less than heretofore considered. Cut No. 788 represents a suitable 
support applied. 



A, A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



155 



We have applied many hundred braces and supports to shortened legs 
in the manner above described, and have the conviction that it is the 
only way by which the requirements may be met in a complete and 
satisfactory manner. Sometimes persons afflicted in this manner wear 
shoes with thick cork soles and heels, or with iron frames attached to 
the bottoms of their shoes. Walking with such appliances is neither 




& 



No. 789. 



No. 790. 



No. 791. 



pleasant, comfortable, nor natural. They only restore length, do not 
support the limb nor conceal the deficiency. 

Cut No. 789 represents an amputation at the ankle joint, with stump 
from the knes down affected with elephantasis; knee, thigh, and hip 
normal. An artificial leg represented by cut No. 790 was devised for 
the case. Cut No. 791 represents a front view of the leg. The socket 
was fitted to receive the leg and stump from the rear. When the stump 
was put in place, a leather sheath, capable of being laced with any 
degree of tension, surrounded both stump and socket; the sheath held 
the stump in the socket and applied a gradual and accommodating 
pressure; the thigh piece and knee joints provided additional support. 
A rubber foot applied to the extremity completed the structure. 



156 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



Cut No. 792 represents a deformed right leg. The leg reaches to the 
ankle and terminates in a bony enlargement, admitting of pressure 
upon the extremity, the shortening amounting to eight inches. 





No. 793. 

Cut No. 793 represents a suitable leg for the same. This leg receives 
the deformed member in a comfortably adapted socket. A rubber foot 
placed at the extremity supplies the want of a foot and the deficiency 
in length. 





No. 794. 



No. 795. 



No. 796. 



Cut No. 794 represents a malformed right leg ; hip, thigh, and knee 
normally constituted, the leg capable of being flexed and extended at 
the knee. Its length was about three-quarters that of the opposite 



A. A. MARES, ARTIFICIAL LIMBS. NEW YORK CITY. 



157 



leg, terminating in one great toe, which grew from the external side, 
passing around to the front. 

Cut No. 795 represents an artificial leg devised for the case. The 
deformed leg was received in the socket and laced in place ; the toe was 
provided for by a protecting pocket ; weight was taken partly upon 
the extremity. An artificial leg without knee-joints and thigh piece 
was applied to this case and worn for a short time. It was discovered, 
however, that the natural knee-joint was insufficiently strong to resist 
side strains, and the child was becoming "knock-kneed." Knee-joints 




No. 797. 



fo. 798. No. 799. 



No. 800. 



and thigh support were immediately applied to the artificial leg. These 
parts strengthened the knee and checked further deflection. 

Cut No. 796 represents the leg applied, and the child standing. 
Since the application of the artificial member, the child has grown 
rapidly in stature and weight; he has attended school, is a promising 
lad, enjoys good health, and engages in all the sports of his playmates. 

Cut No. 797 represents a deformity similar to the above, the left leg 
affected instead of the right. This case was treated "the same as 
No. 794. 

Cut No. 798 represents the form of shortened leg more frequently 
met with, due to hip-joint trouble; knee, leg, and ankle in normal 
condition, needing no lateral support. Cut No. 799 represents an 
extension foot suitable for the case. This foot was constructed with 
a wooden body, fitted to receive the sole of the foot, with the toes 
dropped to within half an inch of the floor. A rubber heel and rubber 
toes were fastened to the wooden body, and the entire structure was 
covered with suitable leather. 

Cut No. 800 represents a shoe to be worn over the extension foot. 



158 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

The extension, when applied and covered by shoe, is represented in 
Cut No. 801. Cut No. 802 presents the appearance of the extension 




m 




No. 801. 



No. 802. 



when dressed. Persons with these appliances walk much better than 
they do with the old style thick sole and high heel shoes, or any sort 






No. 803. 



No. 804. 



No. 805. 



of appliance attached to the bottoms of shoes. In cases of 
equinus, as represented in Fig. 803, a similar extension foot is applied. 
See Fig. 804. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



159 



In talipes equinus there is limited mobility in the ankle, either 
lateral or posterio-anterior; therefore, the simple extension attached to 
the bottom of the foot answers very well, but in cases where there is 
mobility in the ankle, and that mobility is not under control, it is 
necessary to encase the entire leg, as represented in Fig. 806. 

Cut No. 805 represents a foot extension similar to that already 
described, with joints attached to the sides, which provide articulation 
at the ankle. The upper parts of the joints are connected to a leather 
corset which encases the ankle. The object of this device is to provide 





No. 806. 



No. 807. 



a support for a shortened leg in which there is lateral weakness at the 
ankle, the front and back motion being 1 normally strong. 

Cut No. 806 represents a case of talipes equinus, leg atrophied and 
weakened at the ankle. A suitable appliance is exhibited in the same 
cut. The wearer, as seen in Fig. 807, presents a natural appearance, 
and is capable of walking in a greatly improved manner without the 
use of a cane. 

Cut No. 808 represents a double foot appliance devised for a special 
case of shortened leg. This was worn by a lady, and was found to be 
more pleasant and helpful than any of the innumerable appliances 
which she had worn during an experience of many years. The upper 
part is an ordinary shoe, into which the natural foot was placed. The 
lower part ' consisted of a rubber foot, securely attached to the upper 
shoe. Although the lady's affected leg was six inches shorter than 



160 



A. A. MARK**, ARTIFICIAL LIMBS, NEW YORK CITY. 



the natural leg, she had sufficient power in her ankle-joint to be able 
to oppose all strains that might come upon her ankle. 

Resections of the knee-joints or bones of the leg necessitate apparatus 
of the type illustrated in Cut No. 809. The sockets above and below 
the knee sufficiently hold and support the parts, so that safe and pain- 
less walking can be indulged in. Apparatus of this kind are also 
used for weakened knees, broken patellas, or paralyzed knee muscles, 
and by modifications they can be adapted to a great variety of leg weak- 
nesses. It is occasionally found desirable to put automatic knee-locks 
in the joints, and extensor elastic springs in front or flexor elastic 
springs at the rear. The knee-locks obtain rigidity when standing or 




No. 808! 



No. 809. 



No. 810. 



walking, and by moving a slide the knee can be unlocked and per- 
mitted to flex for sitting convenience. 

Gut No. 810 represents a shortened leg with limited motion in the 
knee, the knee capable of flexion, but incapable of extension beyond 
the angle represented in the cut; hip normal, and bottom of foot 
capable of enduring pressure. 

Cut No. 811 represents a leg extension suitable for the case. This 
extension is made with a wooden socket, fitted to receive the leg. A 
comfortable shelf is provided for the foot to rest upon. Knee-joints, 
with prawl and rack and thigh piece that encase the thigh, are also 
provided. The prawls at the knee-joints are operated by levers which 
pass up the back portion of the thigh. When standing or walking, 
and the leg is brought to the point of greatest extension, the prawl will 
drop into the rack and make the leg immovable at the knee. The 
moment the wearer is seated, the lever will press against the seat, which 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 161 



will force the prawls out of their racks and allow the knee to flex. 
By this means the wearer is able to walk safely with rigid knee, and 




No. 811. No. 812. 

bend the knee when sitting without using her hands to operate the 
lock. The apparatus is provided with a rubber foot placed at the 
proper distance to supply the deficiency. 



162 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



PEG LEGS. 

The terms " peg leg," " stick leg," " pin leg," and " bucket leg," are 
synonymous. They designate a crude artificial leg without a foot. 

In remote times peg legs were in almost general use. Peter Stuy- 
vesant wore one in preference to the complicated mechanical leg of 
the seventeenth century, notwithstanding the fact that his friends 
besought him to forego the vulgar peg and import a luxurious arti- 
ficial leg from Holland; but Stuyvesant was too cosmopolitan to heed 
those importunities, and preferred to cling to the commonplace " peg." 




No. 813. 



No. 814. 



In modern times, peg legs are worn temporarily, either to bridge the 
impecunious period, or to serve until the stump has become more 
thoroughly healed. 

Persons are able to stand, stump about, and perform a limited amount 
of labor on them, and are really better off than on crutches, but 
their restoration to the amplitude of their usefulness does not come 
until they have applied artificial legs with rubber feet. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



163 



We disparage the use of peg legs, knowing as we do that they so 
inadequately meet the demand. When one is applied to a below knee 
stump, bearing is usually taken upon the knee, the stump protruding 
from the rear; this has a tendency to impair the knee movement. 

When a peg leg is applied to a thigh stump, a socket is provided that 
receives the stump, and weight is taken about the ischium and per- 
ineum. 

Cut No. 813 represents a peg leg with knee articulation, calculated 
for a thigh stump, to be worn under clothing. It is constructed of 
wood ; the knee mechanism is the same as that described in illustration 
on page 43. The extremity is provided with a rubber tip. The socket 




No: 815. 



No. 816. 



is excavated to receive the stump comfortably; a knee-lock is occa- 
sionally introduced in order to make the knee rigid at times. 

If finished elaborately, it is covered with parchment and coated 
with a flesh-colored waterproof enamel. If cheaply finished, it is cov- 
ered with sheepskin. Price, $50 to $75, according to finish. 

Cut No. 814 represents a peg leg without knee articulation. It is 
constructed the same as the one previously described, except that it is 
incapable of bending at the knee. Price $25 to $40, according to finish. 



164 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



Cut No. 815 represents a peg leg for a knee-bearing stump, with knee 
articulation, to be worn under clothing. The upper part is made of 
wood and leather, fitted to receive the stump, and held in place by 
lacing. A pad is provided at the end of the socket on which the knee 
rests. The knee mechanism is illustrated and described on page 72. 
A knee-lock is frequently inserted to lock the knee when the leg is at 
extension. The lower section is constructed of wood, hollowed to 
reduce weight, the end terminated by a rubber tip. The exterior 
may be covered with parchment, elaborately enameled or finished 
with sheepskin to curtail cost of production. Price, from $50 to $75, 
according to finish. 





No. 817. 



No. 818. 



No. 819. 



Cut No. 816 represents a peg leg for a knee-bearing stump, without 
knee articulation, to be worn under the clothing. 

Price from $25 to $40, according to finish. 

Cut No. 817 represents a peg leg suitable for an amputation between 
the knee and ankle. It is constructed the same as No. 589 without a 
foot. The socket is made of wood, excavated to receive the stump. 
The thigh piece encases the thigh and carries part of the weight above 
the knee. The extremity is terminated by a rubber tip, which" can be 
replaced when worn out. This leg can be finished elaborately or 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 165 

cheaply. If well finished with hard enamel, the price is $50. Cheaply 
finished with sheepskin, $30. 

Cut No. 818 represents a peg leg for a stump extending to a point 
anywhere between the knee and ankle. It is provided with straps 
and thigh belt instead of knee joints and thigh part. The socket 
must be made to fit the stump very comfortably, as the weight of the 
wearer is carried about the stump immediately below the knee. The 
end is terminated with a rubber tip. Price, elaborately finished, $30 ; 
cheaply finished, $20. 

Cut No. 819 represents the usual form of peg leg to be worn on a leg 
stump. It consists of two wooden branches, one running up the out- 
side and well up on the body. The other running up the inner side 
nearly to the crotch. These branches unite below T the point of bear- 
ing, and continue to the ground, terminating with a rubber tip. A 
padded shelf is placed at the proper distance, on which the knee rests. 
Leather straps passing around the thigh, and about the body, hold the 
peg in place. Price, $15 each. This is considered the cheapest form 
of peg leg, and that which is mostly worn. It is adaptable, however, 
only to a stump extending to or below the knee. 

It will readily be seen that the tendency of a peg leg of this character 
is to impair the strength of the knee and lessen its mobility. The 
stump being flexed and held in that position for long intervals of time 
invites evil consequences. We therefore strongly urge applicants to 
look upon this style with little favor. 

Economy frequently influences the selection of the peg leg, and 
oftentimes induces a person to provide himself with one instead of an 
artificial leg with foot. We cannot emphasize too greatly the impor- 
tance of obtaining and using an artificial leg with rubber foot, one that 
will practically remove the disability and contribute to the health of 
the wearer and the maintenance of the functions of the stump. The 
buying of a peg leg may be inexpensive, but the wearing of one entails 
so much sacrifice of comfort and efficiency that the question of a few 
dollars in the cost of purchase should not be taken into consideration. 

There are thousands of impecunious persons who have succeeded in 
obtaining the necessary funds to purchase modern artificial legs, and 
we doubt that there is any person, no matter how poor he may be, who 
will fail in obtaining the necessary amount if he will place the facts 
before his friends and appeal to their humanity. His relatives, society, 
church, or friends are legitimate channels for him to seek aid from 
in any extreme emergency ; pride and modesty often prevent one from 
resorting to these methods, but where so many benefits are at stake, 
the pride or modesty that interferes with the improvement of one's con- 
dition is false, unjustified, and should not prevail. The necessity of 
possessing a useful artificial leg is paramount to every other considera- 
tion. If the decision is finally made for a peg leg, the choice should 
be for that kind that combines the greater number of advantages. Let 
the No. 819 style be the last choice. 



166 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



RUBBER FEET ATTACHED TO OLD ARTIFICIAL LEGS. 

We have endeavored to show in a convincing way the advantages 
of our rubber feet over those made of wood. We have presented the 
points of merit and demerit in both, and leave the matter with the 
reader to draw his own conclusions. 

As artificial legs manufactured with wooden articulating feet are 
always more or less troublesome and expensive to keep in order, and 
as they do not furnish the requisite propulsive power in walking, it is 
deemed advisable to point out a means by which a change can be made 
that will make the old leg far more advantageous. 

We have devised methods by which we can remove the wooden feet 
of artificial legs of any construction, and put rubber feet on in their 
places. This substitution has proved to be of value to those of moderate 
means who have invested their money in a limb that does not fully 
meet the requirements. No matter how a leg may be constructed or of 
what material it is made, a rubber foot can be applied. Our charge for 
removing an old foot and putting on a new rubber one, using the other 
parts of the leg, is $20.00 in each case. We guarantee a connection 
that will be strong and lasting. 

We can accommodate the wearer with a foot of any size, and can 
make the leg any desired length. 

This matter of attaching rubber feet to artificial legs of other con- 
struction than our own, is an accommodation that works to the inter- 
est of the wearer. It is also a plan by which the merits of the 
rubber foot can be put to a test without purchasing an entire new leg. 

We do not advise persons to have rubber feet attached to their old 
artificial legs, unless the fittings of the sockets are comfortable and 
proper, and the knee-joints in fairly good condition. 

Satisfaction will not be obtained in an experiment of this kind unless 
the stump Is accommodatingly received in the socket and unless the 
rubber foot is placed on the leg at a proper angle and in perfect 
alignment. It is hardly possible that a cabinet-maker, carpenter, Or 
mechanic, no matter how skillful he may be, but not familiar with 
artificial leg building, will be able to attach a rubber foot on proper 
angles so that the leg will pose correctly and enable the wearer to bal- 
ance without effort. The ability to make the connection properly 
comes from experience. We therefore- dissuade persons from buying 
rubber feet only, expecting to put them on their artificial legs them- 
selves or having some wood- worker at home do it for them. 

Artificial legs must invariably be sent to us to have rubber feet 
attached. We will keep them only three days, which is the time - 
required to make the change. 



• A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



167 



SUSPENDERS. 

All artificial legs applied to thigh, knee, or leg stumps, should be 
provided with suspenders, or means of support from the shoulders or 
about the waists. Suspenders are absolutely necessary in most cases ; 
in some they are merely helps for beginners, and are soon discarded. 
We therefore apply them to every artificial leg that w r e manu- 






No. 820. 

facture, except those that are applied to ankle-joint and partial-feet 
amputations. 

When a person has become inured to a peculiar form of suspenders, 
and prefers to continue in its use, we will, upon his request, put that 
style on the leg he is ordering; if the making of it does not entail 
an unreasonable expense there will be no additional charge. 



168 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



The roller suspenders herein described are the results of many experi- 
ments, and the kindly suggestions of our patrons. 

Cut No. 820 represents a roller suspender, as designed for a leg to be 
applied to any thigh stump, six or more inches in length. 

The shoulder straps are of two-inch non-elastic webbing. A strip of 
webbing (E) is attached to the right strap, and forms a loop through 





No. 821. 



No. 822. 



which the left strap passes. A piece of webbing (F) stitched to the 
backs of both straps holds them together. The front lower ends of the 
shoulder straps are received into buckles, and the back lower ends are 
terminated by snaps; each hooks into the ends of the roller straps 
which pass around rollers that are attached to either side of the leg. 
Any degree of pressure upon the shoulders can be obtained by regulat- 
ing the front shoulder straps by means of the clamp buckles. When 
the proper degree of pressure is obtained, the buckles are clamped,, and 
are never disturbed, unless the pressure on the shoulder needs to be 
further regulated. When it is desired to remove the limb, the sus- 
penders are detached by unsnapping. 

Cut No. 821 presents a front view of a person wearing a pair of roller 
suspenders for the support of a leg for a thigh stump. 

Cut No. 822 represents the back view. These cuts show the relative 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



169 



positions of the rollers on front and back sides of the socket, also the 
effect of the front loop in holding the shoulder straps in place and the 




No. 823. 



No. 824. 



direction given to the shoulder straps by means of the back cross piece. 
Elasticity is obtained by two short pieces of elastic webbing attached 




to the backs of the shoulder straps at the place where they are con- 
nected and extend to the snaps to which they are attached. 

The action of the suspenders is illustrated in Cuts Nos. 823 and 824. 
All the motion resulting from changes of position takes place about 



170 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



the rollers on the sides of the thigh, instead of on the shoulders of 
the wearer, where they remain immovable, whether the person is 
standing, stooping, walking, sitting, or lying. 




No. 826 



Cut No. 825 represents the wearer lying on a couch at full length. 
From a standing to a sitting posture, or from stooping to erect positions 
the straps roll over a large range, while the shoulder straps have not 




No. 828. 



No. 829. 



moved from their places on the shoulder; all the " let and take up " 
has been about the rollers. 

Price per pair, complete, 14.00. 

The measurement required is the distance from the top of the leg in 
front, over the opposite shoulder to the top of the leg at the back. 

Cut No. 826 represents a clamp, buckle, and spring snap combined; 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



171 



full size, 2 inches. Cut No. 827 represents the same in smaller size, 
\]/ z inches. This buckle is especially gotten up for suspenders for arti- 
ficial limbs. It clamps the webbing without danger of cutting; the 
spring snap admits of rapid attachment to the metal loops at the ends 
of the roller straps. These combined buckles and snaps are used at the 
fronts of nearly all suspenders. 

Cut No. 828 represents a single snap, which is attached to the backs 
of many styles of suspenders ; full size, 2-inches. Cut No. 829 repre- 
sents the same,l^ inches wide. Buckles and snaps are made of strong 
rolled brass, nickel-plated, so as not to be affected by perspiration. 






No. 830. 



No. 831. 



No. 832. 



Price : combination buckle and snap, 25 cents each ; single snap, 15 
cents ; in either size. 

Cut No. 830 represents a roller used in connection with the roller 
suspenders heretofore described. 

Cut No. 831 represents roller for the same purpose, but of smaller 
dimensions and of lighter weight. These rollers are secured to the 
sides of the thigh pieces, and admit of the straps passing through them. 
The frames are made of brass, and the pulleys of wood or hard rubber. 
This combination does not require lubrication and is free from noise. 

Price of either size, 25 cents each, or 50 cents per pair. 

Cut No. 832 represents a roller strap, made of strong leather, espe- 
cially prepared. Each end terminates with a square metal loop. 

Price each, 25 cents, or 50 cents for the pair. 



172 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



Cut No. 833 represents a style of suspender that is especially adapted 
to artificial legs with short thigh stumps. It is also the style that was 
generally used before the roller suspenders were devised. The shoul- 
der straps are of fine elastic webbing, 2 inches wide. The front straps 
are of 2-inch non-elastic webbing ; each front strap passes through a 
metal link, which is attached to the elastic shoulder strap. After 
passing through the metal link the front straps are received into an 
ordinary suspender buckle. The suspenders are attached to the leg 
by means of leather tags and metal D's, screwed to the back and the 





No. 833. 



No. 834. 



No. 835. 



front of the leg. These metal D's admit of side motion, so as to insure 
direct pull. 

Price per pair, $3.00. 

Measurement required is the distance from top of leg at front, over 
the shoulder to top of leg at back. 

Cut No. 834 represents a belt and suspender combined. The shoulder 
straps and belt are preferably of non-elastic webbing. Straps running 
from the belt to the leg are made of elastic webbing. The webbing 
used in this style of suspender is of 2-inch or 1^-inch widths, as the 
case may demand. 

Price, suspender complete, $5.00. 

Measurements required are the distance from the top of leg at front, 
over the shoulder, to top of leg at back ; also the girth measurement. 

Cut No. 835 represents a single suspender, calculated for a leg for 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



173 



amputation below the knee, and also for knee-bearing legs. The 
shoulder strap is of 2-inch elastic webbing. The front strap is 
buckled to a combination buckle. The back of the strap is terminated 
by a simple snap. Both are snapped into metal D's secured to the 
front and the back of the thigh of the leg. This suspender can be 
adjusted by the buckles so that the proper pressure will be brought 
upon the shoulder. When it is desired to disconnect the suspender 
from the leg, it is simply unsnapped. 

Price $1.50 each. 

Cut No. 836 represents a single suspender calculated for the same 







No. 836. 



No. 837. 



No. 838. 



purpose as No. 835. The suspender works on buttons secured to the 
thigh piece, front and back. 

Price $1.50 each. 

Cut No. 837 represents a double suspender for below the knee or 
knee-bearing leg ; the weight is divided over both shoulders. The back 
is made of 2-inch elastic webbing, the shoulder suspenders are of 
1^-inch non-elastic. 

Price each $2.00. 

Cut No. 838 represents a roller suspender designed for a knee bear- 
ing or below the knee leg. Rollers similar to No. 831 are placed one 
on each side; on the thigh a continuous strap passes through them to 
this strap; the shoulder braces are connected; elastic webbing is on the 
rear which is capable of being adjusted; non-elastic webbing passes 
over each shoulder which is also capable of adjustment. 

Cut No. 839 represents the front view of a person with these sus- 



174 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK. CITY. 



penders applied. Cut No. 840 represents a rear view of the same, and 
Cut No. 841 represents the same in side view with wearer seated. 





No. 840. 




No. 841. No. 842. 

Price per set, complete, $3.00. 

Cut No. 842 represents the vest method. It is made of strong 
muslin, fitted to the person and worn under the shirt. Elastic straps 



A. A, MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



175 



are attached to the lower part of this vest, and buckle into straps that 
are attached to the leg. 

In order to obtain the best results, the vest must be made and fitted 
to the person by a tailor. Persons who desire to have their artificial 
limbs constructed from measurements, and choose the vest suspender, 
are required to have the vests made at home, and if sent to us, we will 
attach the straps and make the proper connections with the leg with- 
out additional charge. 



SUSPENDERS FOR WOMEN. 

For obvious reasons the means of suspending artificial limbs to 
women differ from those employed with men. When shoulder straps 
are used they must pass over the shoulders and not press upon the 





breasts. Yokes, girths, or bands must pass around the waists so as to 
take the burden as much from the hips as -the* shoulder. 



176 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



Cut No. 843 represents an excellent style of suspender to be worn 
by a woman who-wears an artificial leg for a thigh amputation. This 
suspender is provided with shoulder straps, and a yoke that passes 
around the waist, resting on the hips. Roller straps are connected 
with the yoke, which pass around rollers attached to the sides of the 
thigh of the artificial leg. The yoke is adjustable by lacing in front 
or on the sides, as may be preferred ; the shoulder and roller straps are 
also adjustable, so as to bring the proportionate weight about the 
shoulders and hips without displacing the yoke. 

Price of this suspender, complete, $5.00. 

A pattern made of cloth or paper should be fitted to the person about 
the hips, and sent to us. The yoke for ordinary cases is 4 inches 
wide ; narrower for smaller persons. 





No. 845. 



No. 846. 



Cut No. 844 represents a yoke suspender with shoulder straps, cal- 
culated for a knee-bearing leg or a leg for amputation below the knee. 
From the yoke up, this suspender is constructed the same as that pre- 
viously described. The manner in which the leg is connected is by 
means of elastic straps attached to the yoke. These straps buckle 
into attachments connected with the thigh piece of the artificial leg. 

Price each, $3.00. 

A pattern of yoke required. 

Cut No. 845 represents a yoke without shoulder straps. This style is 
preferred by women who have broad hips. 

Price each, $2.00. 

Yoke pattern required. 

Women frequently prefer supporting their artificial limbs from their 
corsets, connected by elastic straps as represented in cut No. 846. 
There is no objection to this method ; in fact, it is advised. 

As many women pride themselves upon their frim waists and neat- 
fitting garments, it is all the more desirable that means of leg suspen- 
sion should be light and neat. Straps securely sewed to the corset, 
extending downward and connected with the artificial limb, dispense 
with a vast amount of bulk. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



177 



SUSPENDERS FOR DOUBLE AMPUTATIONS. 

Any of the suspenders described can be so modified as to be adapta- 
ble when two artificial legs are worn. 

Price, style No. 820, modified for double amputations, . $5.00 

" " " 835, " " " " . 3.00 

" " " 843, " " " " . 7.00 

" " Cl 844, " " " " . 4.00 

" " " 845, " " " " . 3.00 

In ordering suspenders, the style selected should be designated by 
the number. All new artificial legs are furnished with suspenders of 
suitable styles, without additional charge. 

Cut No. 847 represents a style, No. 834, suspender modified for 
double amputations. 

This style is more generally adopted for double amputations than any 
other. 




No. 847. 




No. 848. 



Cut No. 848 represents a style of suspender usually applied to legrs 
for very short thigh stumps. Price $5.00. 



178 



A. A. MABKS, AETIFICIAL LIMBS, NEW YOEK CITY. 



DIRECTIONS FOR TAKING MEASUREMENTS AND 
DIAGRAMS FOR ARTIFICIAL LEGS. 

The system of taking measurements is simple, and can be under- 
stood by anyone. After reading the following instructions carefully, 
the simplicity of the process will be apparent. It is calculated that a 
person needing an artificial leg can, with the aid of a member of his 
family, take all the measurements and diagrams required, and not feel 
the necessity of going to the manufacturer or requiring the manufac- 
turer to send a skilled person to him. 



THIGH STUMP. 

Place a sheet of smooth paper (about twenty inches wide by thirty- 
six inches long) on a smooth floor or on a table. Remove all clothing 
from sound leg and stump. Be seated on this paper. Be careful to 




No. 849. 



No. 850. 



have the foot pointed ^directly upward. Begin at the body, draw a 
pencil down the outside of the leg, then around the heel, then up 




No. 851. 



No. 852. 



the inside, as represented in Cut No. 849, continue to the crotch; then 
down the inside of stump, around the end, up the outside, as repre- 
sented in Cut No. 850 ; continue to the hip. The pencil should be held 
upright to insure accuracy. Bend the knee at right angles and lie on 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



179 



the sound leg side. Draw a pencil around the entire leg, from groin 
down the thigh, down the leg, as represented in Fig. 851; continue 
around the foot, up the calf and thigh. Turn to the opposite side, see 
Cut No. 852, and draw a pencil around the stump, from body around 





No. 853. 



No. 854. 



the end and up the rear. Be seated in a chair, place the foot flat dn 
the paper and mark around it, as represented in Fig. 853. 

These drawings, if correctly taken, will be similar to those repre- 
sented in Cuts Nos. 854, 855, 856, and 857. 




No. 855. 



No. 856. 




No. 857. 



No. 858. 



Stand erect, supported by crutches, take a tape line and measure the 
distance from the perineum, or body, to floor, as represented in Fig. 



180 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK: CITY. 



858. Measure the distance from the body to the end of the stump, as 
represented in Fig. 859. Measure the distance from the end of the 
stump to the floor, as represented in Fig. 860. Be seated on a chair 




No. 859: 



No. 860. 



low enough to make the thighs level, measure the distance from the 
top of the knee to the floor, as represented in Fig. 861. Measure the 




No. 861. 



No. 862. 



distance from the under side of the thigh, or popliteal space, to the floor, 
as represented in Fig. 862. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



181 



Pass a tape line horizontally about the sound thigh close to the body ; 
draw it moderately tight, as represented in Fig. 863. In this manner 




No. 863. 



No. 864. 



obtain all the lengths and circumferences of sound leg indicated by 
dotted lines in Fig. 865. 



Length from body, or perineum, to floor, 




AO 


Circumference around leg, close to body, 




A 


" 2 inches below body, 


. 


B 


(C 4 C< 11 


. 


C 


" 6 " " 


. 


D 


8 " " 




E 


10 " "".;■. 




F 


Lateral diameter through center of knee 


(that 




is, the distance through the joint fror 


n the 




interior to the exterior), . 




G 


Circumference just below knee-pan, . 




H 


"* calf of leg, . 


. 


I 


smallest part of ankle, 


. 


J 


1 ' around heel and instep, 




K 


around instep, 


. 


L 


" foot at toe-joints, 


. 


M 


Length of foot, 




N 



No. 865, 



182 



A. A. 



NEW YORK CITY. 



Pass the tape line around the stump close to body. Draw il 
moderately tight, as represented in Fig. 864. Repeat the circum- 
ference of the stump at intervals of two inches, or at places 
indicated by the dotted lines in Fig. 866. All these figures 
should be placed at their relative places on the diagrams 
of sound leg and stump, or written on separate paper. 



Length from body to end of stump, . . . A P 

Circumference around stump close to body, . A 

11 2 inches below, . B 

6 " " . D 

" 8 " " . E 

" 10 " " . . . . ' F 

Length from the end of stump to the floor, . Q Q 

Measurements of the stump should never be taken 
when the stump is swollen. 




p ft 



The following proofs may be applied to test the accuracy j^ 355 
of the length : 

Add the length of the stump (from body to end) to the distance from 
the end of the stump to the floor, and compare the results with the 
distance from the body to the floor of the sound leg. They should be 
equal. In other words, referring to letters on Figs. 865 and 866, 
AO should equal AP plus QG-. 

Answer the following questions : 

Name of patient ? Post office address ? Occupation ? Age ? Weight ? 
Cause of amputation ? When was amputation performed ? Which 
limb amputated ? Has the patient worn an artificial leg ? If so, of 
whose make ? How long ? Name of the party ordering the leg ? His 
address ? Is the leg to be made and fitted in the absence of, the patient ? 
To what address shall it be shipped ? 



KNEE-JOINT STUMP. 

If the stump extends to the knee articulation, the measurements and 
diagrams required of sound leg as well as stump, are the same as those 
required for a thigh stump; therefore the instructions on pages 178 
to 182 should be followed. If it is desired to bear weight upon the 
extremity of the stump, and if the end of the stump is uneven 
and tender in spots, a plaster cast should be made and sent with the 
order. Methods of taking plaster casts are explained in their order: 
consult index. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



183 



BELOW-KNEE AND KNEE-BEARING STUMPS. 

If the stump extends below the knee to any point above the ankle, 
the following directions should be followed : Place a sheet of smooth 
paper about twenty by thirty-six inches on a smooth floor or table. 
Remove all clothing from the sound leg and stump. Be seated on the 
paper. Be careful to have the foot pointed directly upward. Begin at 




^» 




No. 867. 



No. 868. 



the body, draw a pencil down the sound leg from the hip to and around 
the heel up to the crotch, as represented in Cut No. 867. Draw the pencil 
entirely around stump, beginning at the crotch and passing down the 
thigh and stump, around the end, up the exterior side to the body, as 
shown in Cut No 868. The pencil should beheld perpendicularly to in- 




No. 869. 



No. 870. 



sure accuracy ; when passing up the interior of the sound leg and stump 
it should be carried close to the crotch. Bend the knee at right angles 
and lie on the sound leg side. Draw the pencil around the entire leg 
from groin down the thigh, down the front of the leg, around the foot, 
up the calf and thigh, as represented in Fig. 869. Turn to the opposite 



184 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



or amputated side and draw a pencil around the thigh and stump when 
the stump is at full extension, as represented in Fig. 870. Without 
changing the position of the body, bend the knee so that the stump 
will be at right angles with the thigh, then draw a pencil from body 
around the thigh and stump. Be seated on a chair, place the foot flat 





No. 871. 



No. 872. 



on a paper and mark around it, as represented in Fig. 871. These 
drawings should be similar to those represented in Figs. 872, 873, 
874, and 875. Stand erect, supported by crutches. Take a tape line 
and measure the distance from the perineum or body to the floor, as 
represented in Fig. 876. Measure the distance from the body to the 





No. 873. 



No. 874. 



No. 875. 



end of the stump, as illustrated in Cut No. 877. Measure the distance 
from the end of the stump to the floor, as represented in Cut No. 878. 
Be seated in a chair low enough to make the thighs level. Measure 
the distance from the top of the knee to the floor, as represented in 
Fig. 879. Measure the distance from the under side of the thigh, or 
popliteal space, to the floor, as represented by Cut No. 880. Measure 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 185 



the distance from under side of thigh, or popliteal space, to the end of 
the stump. Stand erect and measure the circumference of the 





No. 876. 



No. 877. 



thigh of the sound leg close to body, as represented in Cut No. 
881. 
Pass the tape line around the thigh of the amputated limb, close to 





No. 878. 



No. 879. 



the body; draw it snugly, as represented in Fig. 882. In like manner 

take all the measurements of both legs called for in Figs. 883 and SS4. 

If a knee-bearing leg is required, give, in addition to all the meas- 



186 



A. A. MASKS, AETIFICIAL LIMBS, >'EW YOKE. CITY. 



ure merits and diagrams above called for. the distance from the under 
side of flexed knee to the floor, vrhen hips are level. 
All the measurements, lengths, and circumferences should be placed 




No. 880. 



Xo. 881. 



in plain figures at their relative places on the diagrams, or written in 
full on a separate paper. 




No. 882. 



All the lengths and circumferences of sound and amputated legs 
that are required are indicated by the dotted lines in Cuts'Xos. 883 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



187 



Length from body, or perineum, to floor, 
Circumference around leg, close to body, 
" 2 inches below body, 

u 4 " " 

C< g II ii 

ic 8 ii ii 

ii 10 ii ii 

Lateral diameter through center of knee (that is, 
the distance through the joint from the interior 

to" the exterior), 

Circumference just below the knee-pan, 
" calf of leg, 
" smallest part of ankle, 
" around heel and instep, 
" " instep, 
foot at toe joints, 
Length of foot, 



Length from body to end of stump, 

Circumference around stump, close to body, 

" 2 inches below, . ... 

" 4 " " 

ii g ii ii 

II Q II (I " 

Circumference at the smallest place above the knee, 
Lateral diameter through center of knee, 
Circumference at lower edge of knee-pan, 
" 2 inches below, 

II A II II 

II g II II 

II gllll 

II 1Q II II 

12 " 
Length of stump below knee, measured from back 

of knee (when bent at right angles) to end. 
Distance from end of stump to floor, . . . TO 

Measurements should never be taken when the stump 
is in a swollen condition. 



883. 



No. 884. 



The following proofs may be applied to verify the lengths : 
Add the distance from the body to the end of the stump to the dis- 
tance from the end of the stump to the floor. The sum should be 
equal to the length of the sound leg from the body to the floor ; or, 
referring to the small cuts, Nos. 883 and 884, AO should be equal to 
AT plus TO. 

The distance from the popliteal space to the end of the stump, 
added to the distance from the end of the stump to the floor, should 



188 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

be equal to the distance from the popliteal space of the sound leg to 
the floor. 

Answer the following questions : 

Name of patient? Post office address ? Occupation? Age? Weight? 
Cause of amputation ? When was amputation performed ? Which 
limb amputated ? Has the patient worn an artificial leg ? If so, of 
whose make ? How long ? Name of the party ordering the leg ? His 
address ? If the leg is to be made and fitted in the absence of the 
patient, how shall it be shipped, and to what address ? 



ANKLE-JOINT OR PARTIAL FOOT STUMPS. 

If it is decided to apply an artificial leg to a stump extending to the 
ankle or in the body of the foot, the artificial leg to have knee-joints 
and thigh support, it will be necessary to take all the diagrams 
and measurements called for on pages 183 to 187 ; but if an arti- 
ficial leg without knee-joints and thigh support is to be used, it will 
not be necessary to take diagrams or measurements of either thigh. 
Those of sound and amputated legs from the knees down will suffice. 

In addition to the measurements and diagrams, a plaster cast of the 
amputated limb, from the knee to the extremity of the stump, should 
be made. 

Methods of taking plaster casts are explained in other parts of this 
book : consult index. 



MEASUREMENTS AND DIAGRAMS REQUIRED WHEN 
BOTH LEGS ARE AMPUTATED. 

If both legs are amputated above the knees or in the knee-joints, or 
if one leg is amputated above the knee and the other in the knee, front 
diagrams of each stump should be made, as represented in Cut No . 850, 
page 178, and side diagrams of each stump, as represented in Cut No. 
852, page 178. 

The patient is to be seated on a sheet of paper, as shown in Cut No. 
850. A pencil is to be carried perpendicularly down the outside of left 
stump, around the end; then up the inside to the crotch; then down 
the inside of right leg, around the end, up the outside, to the hip. The 
patient should then turn to the right side, with outside of the right 
stump resting on the paper. Carry the pencil perpendicularly down 
the front of the right stump, from groin to end ; then around the end, 
and up the back to the buttock; the patient should then turn to 
the left side, and a side diagram of the right stump be taken in the 
same manner. 

The length of each stump, from crotch to the end, should be taken 
by the tape line. Circumferences should then be taken; first, close 



A. A. MAEKS, ARTIFICIAL LIMBS, NEW YOEK CITY. 



189 



to body, on a plane with the crotch ; second, two inches below the 
crotch; third, four inches below. In this manner, the circumferences 
of each stump should be taken at intervals of about two inches. These 
lengths and circumferences should be written on the diagrams in their 
respective places. 

Answer the following questions: 

Name of patient? Post office address? Age? Occupation? Weight? 
Cause of amputation ? When was each leg amputated? Has the 
patient worn artificial legs ? If so, of whose make ? How long ? 
Name of the physician or party ordering the legs ? Are the legs to be 
made and fitted from measurements, in the absence of the wearer? To 
what address shall they be shipped? 



ONE LEG AMPUTATED ABOVE OR IN THE KNEE, AND 
THE OTHER BELOW THE KNEE. 

The diagrams required when one leg is amputated above or in the 
knee, and the other below the knee, are the following : First, 
front diagrams of both legs ; this can be done by placing the subject on 
a sheet of paper thirty-six inches long and twenty inches wide, both 
limbs naked, mark around each in the following manner : Beginning 
at the hip of the left leg, carry the pencil down the left side, around 





No. 885. 



No. 886. 



the end, up the inside to the crotch, then down the inside of the right 
limb, up the outside, as represented in Cut No. 885. Let the patient 
lie on his long stump side so that the outside will rest on the paper, 
draw a pencil around that limb from the groin down the front, around 
the end of the stump, up the back to the buttock. This diagram should 
be made with the stump extended and also with the stump flexed, as 
represented in Cut No. 886. Let the patient lie on the short stump 
side, carry the pencil down the front of the leg from the groin to the 
end, around the end and up the back to the buttock, as represented in 
Cut No. 887. 

The measurements required are as follows: The distance from the 
body or crotch to the end of each stump ; this can be taken by a tape 



190 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

line. The distance from the popliteal space (or back of knee) to end of 
Jong stump. The circumferences of each thigh and stump, as repre- 
sented in Cuts No. 888 and 889, beginning at the thigh and repeating at 
intervals of two inches. These measurements and circumferences 



No. 887. No. 888. 

should be marked in their relative places on the paper containing the 
diagram. Answers to the following questions should also be placed on 
the paper: Name of patient? Post office address? Age? Occupation? 
Weight? Cause of amputation? When were legs amputated? Has 




No. 889. 

the patient worn artificial legs? If so, of whose make? How long? 
Name of the physician or party ordering legs? Are the legs to be made 
and fitted from measurements in the absence of the wearer? To what 
address are they to be shipped? 



BOTH LEGS AMPUTATED BELOW THE KNEES. 

The diagrams required in case both legs are amputated below the 
knees are as follows : Front diagrams of each thigh and stump, which 
are made by having the patient seated on a sheet of paper thirty-six 
inches long by twenty inches wide, with both limbs naked, then mark 
around each in the following manner: Start at the hip of the left leg, 
carry the pencil down the outside, around the end, up the inside to the 
body, down the inside of the right leg. See Cut No. 890. Around the 
end, up the outside to the hip. Let the patient lie on the right side, 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



191 



mark around the stump and thigh, thus obtaining a side diagram of that 
leg; this diagram should be made twice, first, with the stump extended, 
and second, with it flexed at right angles, as represented in Cut No. 
891. Then let the patient lie on the left side and mark around thigh 
and stump, showing a side view of the same. This diagram should also 




No. 890 



be taken twice, first, with the stump extended, second, with the stump 
flexed at right angles, as represented in Cut No. 892. Circumferences 
of each thigh and stump should be taken, beginning on a line directly 
around the thigh close to the crotch, repeating at intervals of two 
inches, as represented in Cuts No. 893 and 894. These measurements 
should be placed at their relative places on the diagrams. The length 
of each stump from the crotch to the end, also the length of each from 




No. 892. 



the popliteal space (or back of knee) to the end of the stump, should 
be taken and marked on the diagrams. 

If it is desired to make the artificial legs of sufficient length to ele- 
vate the wearer to a given height, it will be necessary to give the 
length from the top of head to the end of long stump, which can 
be obtained by the patient lying on his back at full length, and meas- 
uring by the tape line the distance required. 
Answers to the following questions should be placed on the diagrams : 
Name of patient? Post office address? Age? Occupation? Weight? 
Cause of amputation ? When was each leg amputated? Has the patient 



192 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



worn artificial legs? If so, whose make? How long? Name of the 
physician or party ordering the legs? Are the legs to be made and 
fitted from measurements in the absence of the wearer? To what 
address are they to be shipped? 

If both legs are amputated in the ankle-joints or in the feet, all 
the measurements and diagrams called for under the head of "Both 





No. 893. 



No. 894. 



Legs Amputated below the Knees," should be given. If artificial 
legs are to be applied that do not extend above the knees, it will not be 
necessary to send any measurements or diagrams of the thighs of 
either leg. Plaster casts are only required of stumps that extend 
to the knee-joints, ankle-joints, or stumps that result from partial 
foot amputations. Instructions for taking plaster casts are explained 
in other parts of the book. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 193 



THE IMPORTANCE OF APPLYING ARTIFICIAL LEGS 
TO YOUNG AND GROWING CHILDREN. 

The first thought that comes to the parents of a crippled child is the 
improvement of the child's condition ; what can be done to protect the 
injured parts ; to make the child less dependent on others ; to enable 
him to get about and share the en joyments of childhood as other chil- 
dren do, and thus mitigate his disabilities? The thought then obtrudes 
itself, that the child is young and growing, and that an artificial leg 
will, on account of his growth and development, soon become out- 
grown and unsuitable, and that the expense of renewing or remodel- 
ing will be more than the benefits will justify or the financial abilities 
of the parents permit. Will it not be better to wait until the child has 
attained his full growth? Parents are naturally solicitous for the wel- 
fare of their offspring, and are willing to meet any reasonable sacrifice 
in order to faithfully discharge those duties devolving upon them as 
parents, if they can be assured that substantial benefits will be derived. 

A child, no matter how young, is as greatly disabled by the loss of a 
leg as an adult. If one leg is lost, the child becomes dependent on 
crutches ; and if both legs are lost, he becomes the subject of a rolling 
chair, or has to be carried the same as an infant, or is obliged to hitch 
himself about on his haunches. Aside from the inconvenience and the 
humiliation, these methods are unnatural and are sure to leave their 
unwholesome influences on the limbs, stumps, and joints, as well as 
on the physique of a developing child. If the child has lost but one 
leg, and walks for any great length of time on a pair of crutches, his 
shoulders will, from the weight of his body, become pushed upward, 
his neck will appear to settle in his chest, his chest will become col- 
lapsed, and his spine will fail to acquire the sustaining strength that 
the habits of manhood will demand. 

If the child discards one crutch, as most energetic children do, the 
effect of being suspended from under one shoulder will be that of 
canting the body to the opposite side, elevating one shoulder above 
the other, the development of one side of the body and the arrested 
development of the other, and the tilting of the pelvis. If the 
using of one or a pair of crutches is continued through the growing 
period, the disproportions resulting from unequal development will 
bring embarrassments that will last through life. The stump, being 
pendant from the body, performing no functions whatever for a long 
period, will become poorly adaptable to the uses of an artificial leg. 
The muscles will become atrophied, the joints powerless, and the 
range of motions will be lessened. The wearing of an artificial leg 
under these conditions will be very troublesome, and the task of 
disciplining the stump will be quite discouraging, and it is doubtful 
that all the disproportions, enervations, and limitations of motion will 
ever disappear. 

We can cite many cases where the neglect to apply an artificial leg 



194 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

to a growing child has been the cause of physical weakness that has 
not been possible to correct. Contracted hips and knees, weakened 
spines, deflected and rotated stumps, are a few of the many ills that 
have been traced to this neglect ; delays are therefore dangerous. 

In double amputations, the failure to apply artificial limbs in youth 
invites more serious consequences. The stumps become forced into 
abnormal positions, and subjected to such unnatural influences that 
the wearing of a pair of artificial legs is greatly encumbered. The art 
of balancing is forgotten, and has to be acquired again. The hip-joints, 
having remained in flexed positions the greater part of the developing 
period, become more or less set, and extension becomes difficult and 
painful when the erect position is attempted. 

An artificial leg applied to a child, no matter how young, supplies a 
support to the amputated side that is the nearest approach to nature 
in its effects on the system. While wearing the artificial leg the 
child has the freedom of his arms, and his joints and muscles are in 
a state of natural activity, being propped from the knee or pelvis 
instead of from the shoulders. His spine, his chest, and his shoulders 
are not under unnatural and distorting influences. They are as free 
to perform their functions as if the child had never lost a limb. All 
the parts of the child maintain their relations, and develop naturally 
and symmetrically. 

A child always becomes expert in the use of an artificial limb, or 
in the use of a pair of artificial limbs, and his youthful nature impels 
him to mingle with other children, engage in the same sports, 
run, romp, wrestle, frolic, and indulge in all the hilarities of his 
companions. This variety of exercise makes the child strong, mentally 
and physically, keeps him healthy, and builds the foundation for that 
vigorous manhood and active business life that lie before him. Noth- 
ing should be permitted to separate him from those wholesome 
influences. The loss of one or both limbs should be immediately 
replaced, so that the child will be permitted to do as other children do, 
and not become dwarfed, ill-shapen, sickly, incapacitated, an object of 
pity, unequal to the struggles of life, a life-long dependent on others. 

A child will undoubtedly outgrow his artificial leg, but this does not 
entail a serious loss, as it can be altered in length and size to accom- 
modate such growth and development. The expense attending such 
changes is not great. No greater than the expense of changing or 
renewing crutches, or repairing rolling chairs. 

The only growth of the child that affects the length of the artificial 
leg is the growth that takes place in the sound leg from the knee to 
the floor. A child may, in the course of two years, grow four inches 
in his entire height, but the growth in the sound leg from the knee 
to the floor will be less than an inch. It is therefore evident that a 
child growing as much as four inches in eighteen months (which is 
extraordinary), will not require his artificial leg to be lengthened 
over one inch in eighteen months (if his leg is amputated below the 
knee). The frequency with which an artificial leg, worn by a grow- 
ing child, is lengthened, is about once in eighteen months, and the 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



195 



expense attending each lengthening is sometimes $3.00, and seldom 
over $5.00. In families where economy has to be exercised to an 
extreme degree, the lengthening of the leg can be deferred, by increas- 
ing the thickness of the sole and heel on the shoe worn on the artificial 
foot. 

The size of the leg can be increased, and the foot can be expanded, 
and by these methods the leg can be made to last from five to ten years. 
It will thus be seen that in extreme cases a child can be supplied with an 
artificial leg, and the leg be kept in proper length, at an expense less 
than $5.00 a year; less than ten cents per week, and a little over a cent 
a day. We can hardly conceive of a parent who is so poor that he 
cannot meet this expense, or who is so heartless that he would rather 
see his crippled child hobbling about on crutches during his adoles- 
cence merely to save so small an annuity. 






No. 895. 



No. 896. 



No. 897. 



The most important matter to consider is that of duty. All parents 
are bounden by the laws of nature, as well as by the laws of state, to 
perform those services that will promote the health and comfort of their 
offspring, to care for them in sickness, to lessen their afflictions, and alle- 
viate their sufferings. It appears to us that it is a flagrant violation of 
those laws for a parent to require his child to walk on crutches, subject- 
ing him to the dangers of impaired health and arrested development, 
when an artificial leg can be so easily obtained and so cheaply main- 
tained — a leg that will perform such important work in ameliorating 
the child's condition, contributing to his happiness and restoring him 
to his usefulness. Crutches should be considered temporary supports, 
to be used only at times of necessity. An artificial leg should be 
regarded as indispensable, more important than line clothing, and next 



196 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

in importance to the food that is required to sustain life. We have no 
doubt that every mother and every father who carefully considers the 
facts as above presented, will feel little hesitancy in deciding in favor of 
the earliest possible application of an artificial leg, or a pair of artificial 
legs, to their unfortunate children. If their financial resources are 
limited, they should feel no disgrace in calling upon their friends for 
assistance, as the urgency is so great as to justify them in resorting to 
extreme measures, and thus arrest their child from a life of torture and 
embarrassment, and save themselves the censure and rebuke that 
neglect of this kind will bring in later years. 

Look at the child who is required to go about on a pair of crutches, Cut 
No. 895. See how his shoulders are pushed out of their natural lines ; 
notice how his head leans forward, chest sunken, and how frightfully 
disfigured he appears. Look at the child who hobbles about on one 
crutch, Cut No. 896. See how one shoulder is raised higher than the 
other ; notice how his body is thrown to one side, sound leg deflected, 
neck crooked. Now, look at the child who has been cared for humanely, 
Cut No. 897 ; who has been furnished with an artificial leg and propped 
in a natural way on the amputated side. He is the picture of sym- 
metry, his health is robust. No one would suspect that anything 
unusual had occurred to him, although the child has lost a leg. His 
artificial leg has become second nature to him ; he is forgetful of the 
fact that he is crippled ; he never realizes his own condition, and 
never admits that he is disabled. He does everything that his com- 
panions do ; he is in the ball match with them ; he rides the bicycle, 
skates, dances, and is not denied a single privilege accorded to those 
in possession of their natural extremities. "To clinch the nail of 
theory with a few blows from the hammer of experience," we will cite 
a few cases that have come under our observation. 

Cuts Nos. 898 and 899 represent Mabel Thompson. When this child 
was less than nine months old, it was found necessary to amputate 
her left leg very close to her knee. After the child had recovered 
from the operation it was discovered that the tendons of the knee 
were contracting, and that the stump was being drawn into a flexed 
position. The mother became alarmed and consulted her physician. 
It was feared that if the child were permitted to remain without an 
artificial limb, that she would, in a short time, lose the use of the right 
knee-joint. The child had not begun to creep, and the thought of 
applying an artificial leg to one so young could hardly be entertained. 
It was evident, however, that if an artificial leg was applied, the stump 
would be forced into such activity that the knee mobility would be 
preserved. An artificial leg was made and applied. The socket was 
made to fit the stump snugly, the joints were placed on the sides to 
harmonize with the natural knee-joint ; a thigh piece encased the 
child's thigh, and the leg was terminated with a rubber foot. The arti- 
ficial leg would swing when the child was seated or being carried, and 
thus force the stump to move at the knee. In a few months the child 
began to creep. The mother was surprised one morning to find her 
standing by a chair, putting a share of her weight on the artificial 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



197 



leg. It was not long before she began to walk, then run and play. 
The leg was lengthened quite frequently, and enlarged several times. 
When she was about five years old the leg was renewed. At this 
writing (1896) she is fourteen years of age, runs or romps about the 
same as other children, goes to school, and is as happy and jolly 
as other children. Although her parents are in moderate circum- 
stances, they have never regretted that an artificial leg was applied 
when the child was young. On the contrary, they realize that by 
their timely attention to her needs, they have preserved a good 
stu«ip and retained a valuable knee motion, and they enjoy the 
consolation of having performed their duty in putting their child in a 





No. 898. 



No. 899. 



condition in which she has grown and developed into a strong, comely, 
and vigorous young lady, who is to-day the pride of the family. 

Cut No. 900 represents another interesting case. Carrie Kimtz, 
when seven years old, was run over by a carriage and had her left leg 
so badly mangled that it had to be amputated a short distance below 
the knee. An artificial leg was applied as soon as the stump had 
healed. This was done by advice of the family physician, the late 
Dr. James Knight. The child grew up and developed into a lady of 
graceful proportions. She is now married, and the fond mother of an 
interesting family. 

Cut No. 901 is an engraving from the photograph of the lady as she 
appears now. 

Thomas Kehr, when eight years of age, was run over by the cars. 
Both of his legs were crushed. The right was amputated four inches 
below the body and the left two inches below the knee. As soon as the 



198 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



child recovered from the amputation and his stumps were healed, Dr. 
Brady, his physician, advised the application of a pair of artificial 




No. 900. 



No. 901. 



legs. The legs were applied in December, 1875, when he was ten years 
old. It may be interesting to read Dr. Brady's letter, written on the 
case in 1876 : 



Brooklyn, N. Y., May 16, 1876. 
Mr. A. A. Marks : 

Dear Sir: I have thoroughly examined the case of the boy, Thomas Kehr, of 
this city, who has been wearing a pair of your artificial legs for the past six 
months. About a year and a half ago he was run over by a train of the S. S. R. R. 
of Long Island, and both of his lower limbs were so crushed that I amputated 
them, the one well above the knee, the other about one inch and one-half below. 
At the time of the operation many expressed a wish that death would occur, as 
the lad being very poor it was thought that his future would not only be a bur- 
den to himself, but that his future support, should he reach man's estate, would 
depend upon the charity of the public, as it was considered about an impossi- 
bility for him to'serviceably use artificial limbs. 

I am thankful that I can say that you have made his future worth the living, 
by giving him the meafns of good locomotion. 

I saw him two weeks after he had put them on for the first time, and it 
astonished me greatly to see the remarkable use' he had already acquired ; since 
then I have seen him many times, and have each time seen marked improve- 
ment in the freedom of use in walking. 

Within the past week I saw him walking on the street without even the help 
of a cane, and so little lamed that any person seeing him would not for the 



A, A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 199 



moment have the least suspicion that he was using legs other than such as 
nature provided. 

I feel competent to say that in this case your artificial limbs have proved 
a grand success. I have never before seen artificial limbs which in action 
approached so near that of perfection. 

I attribute-the wonderful success in this boy's case mainly to the superior 
results achieved by your inventions. 

Especially can attention be called to the use of the rubber foot, thereby dis- 
pensing with the ankle-joint, thus giving the wearer an elastic, reliable, and 
sure footing, which must greatly relieve him from the care and watchfulness 
which must certainly be required by those who wear artificial limbs having 
jointed feet. 

Your plain and simple mode of construction of artificial legs is to my mind 
unquestionably the best, and when asked by legless persons as to whose make of 
artificial limbs would prove the best to secure comfort and utility, I most 
decidedly say, without any hesitation, Marks'. 

Very respectfully, 

Samuel J. Brady, M. D. 



Mr. Kehr is at this writing" (1896) a man about thirty years old. He 
is active, capable, and energetic. He is constantly employed, and has 
no difficulty in earning his livelihood and laying aside some of his 
earnings for the "rainy day." His present good health, excellent 
walking and balancing- abilities, strong and powerful stumps, can be 
ascribed entirely to the fact that artificial legs were applied to him 
when he was so young". If he had been neglected there is no doubt that 
Mr. Kehr would to-day be a helpless object of pity. Neither he nor his 
parents have ever felt the burden of keeping him supplied with artifi- 
cial limbs of proper proportions, although his parents were in very 
poor circumstances. 

Cut No. 902 represents a girl who had her right leg amputated below 
the knee in 1884, when she was eleven years old. Cut No. 903 repre- 
sents her with an artificial leg applied five months after the amputa- 
tion. She has worn the same limb for six years; had it lengthened 
several times. She is now a young lady of comely proportions, enjoy- 
ing vigorous health. In two weeks after the leg was applied she 
walked a distance of two miles to church ; after service she walked the 
same distance to her home. Her progress was rapid, 'and in a brief 
time she indulged in all the pastimes of childhood. She is now wear- 
ing her second artificial leg. She and her parents have always felt 
thankful that by the timely advice of their physician an artificial leg 
was applied before her stump had an opportunity to become irre- 
parably impaired. 

Annie L. Beckwith had her leg amputated above the knee in 1887. 
She had an artificial leg applied two months after the amputation, 
when she was seven years of age. The leg has been lengthened three 
times in five years. She procured a new leg in 1892, not from 
necessity as much as from the desire to have a new leg. The second 
leg has been lengthened once. She is now (1896) sixteen years old, 
and weighs one hundred pounds. When first leg was applied she 
weighed forty pounds. 

Manuel Parraga, San Salvador, Central America, had his leg ampu- 
tated above the knee in 1876, when eleven years of age. An artificial 



200 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



leg was applied immediately. His weight at the time was seventy-five 
pounds. The lad has developed into a man weighing two hundred 
pounds, thirty-one years of age. He is strong, healthy, and has a 
model stump, and has ever been grateful that an artificial leg was 





No. 902. 



No. 903. 



applied so soon after the amputation, 
which he wrote in 1883: 



We append the testimonial 



Perez & Parraga. 
San Salvador, Central America, January 24, 1883. 
Mr. A. A. Marks, New York : 

Most Esteemed Sir : I have been for a long time desirous of writing you and 
expressing niy continued satisfaction with the artificial leg you made for me, 
and now avail myself of the opportunity. 

It is six years since I obtained an artificial leg from you ; during this period 
I have not had an opportunity to find the least fault with it. I walk very much 
and without a cane or support. I suffer no pain or uneasiness from it. 

Since I have returned to Central America, I find it necessary to make long 
journeys on horseback. In this, the leg assists me very much. I pride 
myself on my easy and graceful movements, and the facility with which I 
mount and dismount. 

The india-rubber foot which is on the artificial leg is a most excellent inven- 
tion ; without it, I question my ability to walk with safety in this country, the 
streets are so very rough and stony. 

Your attentive friend, 

Manuel A. Parraga. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



201 



John Jerome Booth, son of Dr. J. P. Booth of Needles, Cal., had 
his leg amputated when seven years old, on account of a railroad acci- 
dent. An artificial leg was applied a year after the accident. Weight 
of the child, fifty -seven pounds. The leg was worn eight years, and 
was lengthened five times. In 1891 the leg was renewed, which has 
since been lengthened twice. The subject is now twenty-one years of 
age, and weighs one hundred and sixty-five pounds. Under date of 
November 10, 1887, Dr. Booth wrote a very commendatory letter, in 
which he states that " My son runs, jumps, climbs, and skates as well 
as any of his companions, and the closest observers, when informed of 
his misfortune, are at a loss to determine which is the real and which 
the artificial leg." 

George G. Griswold, left leg amputated below the knee, when twelve 




No. 904. 

years of age ; artificial leg applied within one year after amputation. 
We append a letter written by his father : 



Hartford Co., Conn., March 7, 1896. 
A. A. Marks. 

Dear Sir : In reply to your inquiry, about the advisability of applying arti- 
ficial legs to growing children, I beg to say that I had one of your legs applied 
to my son George when he was thirteen years old. The leg was made and 
fitted from measurements without requiring my son to leave his home. From 
the day he received the leg to the present time, he has worn it constantly, 
without requiring any repairs or alterations. I hardly know of anything that 
he could not do that any other boy of his age with two sound legs couhi do. 
He could walk, run, or skate, play ball, or climb trees with any boy of his 
age. When he was sixteen we moved to another town, and for about a year 
scarcely a single schoolmate or neighbor ever suspected that he ever wore 
an artificial leg. 

I do not believe that it is possible to find another make of artificial leg that 
is so well adapted to growing children, as yours. I have never regretted 
having applied an artificial leg to my son George on account of his tender age. 

Yours truly, 

Ward H. Gkiswold. 



202 A. A. MARKS. ARTIFICIAL LIMBS, NEW YORK CITY. 



Cut No. 904 represents the boy, Griswold, at the bat. This cut illus- 
trates forcibly the facility with which a child who has lost a leg can be 
made equal to his companions in the ability to enjoy boy life. 

William T. Wilson, when fifteen years of age, was run over by a 
railroad car and had his leg mangled so greatly that amputation was 
necessary. A few months after the amputation he had an artificial 
leg applied. He weighed one hundred and ten pounds, and was at the 
period of life when growth and development promised to be rapid. 
The artificial leg was lengthened twice in four years. A new leg was 
applied in 1885, which he has worn for ten years; present age twenty- 
nine; weight, one hundred and thirty pounds; occupation, stock 
raiser. In 1888 the young man wrote the following letter : 



Atlanta, Ga., January 5, 
Mr. A. A. Marks. 

My Dear Sir : I am so much pleased with my artificial limb that I feel like 
urging everyone so unfortunate as to lose a leg to try one of yours. It is light 
and simple, never getting out of fix. During the seven years I have used mine 
it has never given me the slightest inconvenience, but is always ready for use. 

I went to military school one year, and beat the drum, marching in front of 
the company one hour every day. Coming home, I went into the insurance 
business, and was an insurance solicitor for over a year, keeping me on the go 
all day long in rain, snow, and sleet, and I never used a stick. After that I 
went into the real estate business with my father, and on one occasion walked 
sixteen and one-half miles on a railroad track in the rain, to transact some 
business. In this walk I crossed two trestles over fifty feet high, and over a 
new road that was very muddy. I regard the rubber foot as the greatest 
invention of this century, it being noiseless and filling the shoe so perfectly. It 
is almost impossible to say which is the artificial foot. I have gone with new 
friends for months, and they never once thought I had an artificial limb. 

I can dance, act on the bar, skate on rollers, and run. 

Yours, etc., 

W. T. Wilson. 

James Good, at the age of thirteen, was run over by the cars. Leg 
amputated below knee. Seven months after amputation an artificial 
. leg was applied ; age fourteen ; weight, eighty pounds. Leg was length- 
ened every eighteen months until 1875, when it was renewed. The 
boy grew to be a man of large and heavy proportions, and at this writ- 
ing (1896) is a locomotive engineer. In 1887 he wrote the following 
testimonial : 

Jersey City, N. J., November 1, 1887. 
Mr. A. A. Marks. 

Dear Sir : I have worn your artificial leg for the past sixteen years and have 
found it entirely satisfactory. 

I have been employed as locomotive fireman, and at present am locomotive 
engineer, and have never found any difficulty in performing my duties. 

Yours respectfully, 

James Good. 

George WV Sheridan, son of General George A. Sheridan, at the age 
of ten was thrown from a carriage ,J>y a runaway horse; one leg was 
crushed and had to be amputated below the knee. Nine months later 
his solicitous mother insisted on an artificial leg being obtained, in 
opposition, however, to the advice of others. The following letter, writ- 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 203 

ten by his father in 1885, tells the story of how completely an artificial 
leg restored the boy. Sheridan is now twenty-six years of age, is a well 
developed man of large proportions, and always refers to the early 
application of an artificial leg to his stump with much gratitude. 



New York City, July 1, 1885. 
My Dear Doctor : The last leg you made for my son came promptly, and 
is satisfactory. The boy is now fifteen years old ; he has worn a leg of your 
make for the past five years, and always with comfort and satisfaction. When 
visiting him at his school awhile since, I found he was out for a day's fishing ; 
when he returned and stated where he had been, the teacher remarked he had 
walked at least twelve miles. George skates on steel or roller skates, rides a 
bicycle, and, in short, enjoys to the full tke usual sports of boys of his own 
age. For this we have you to thank more than anyone in the world. 

Yours truly, 

George A. Sheridan. 
To Dr. A. A. Marks, Broadway, New York. 



Hattie Moore, at the age of thirteen, had her foot amputated at the 
ankle. In six months after the operation an artificial foot was 
applied. She wore the leg five years without lengthening. The 
growth of the natural foot from the ankle down was not great enough 
to require any alterations in the artificial foot. In 1887 she was nine- 
teen years old and procured a new foot. We append her testimonial. 



Chenango County, N. Y., November 9, 1887. 
Mr. A. A. Marks. 

Bear Sir: My foot was amputated when but a child of thirteen, and as 
soon as it was sufficiently healed, I had one of your admirable rubber feet 
applied, made and fitted from measurements. It fitted me as perfectly as though 
I had gone to New York and had the foot fitted by your own hand. I have 
used the foot four years now, to the untold satisfaction of myself and the 
utmost gratification of my friends, who often tell me they would never notice 
anything peculiar about my walk. I have lived with people for months with- 
out their discovering that I was lame. 

During the greater part of the time since I have worn your artificial foot, 
I have attended a boarding school, with its usual number of stairs, which I 
have run up and down with the greatest ease. I am at present doing a daugh- 
ter's part of the housework, standing upon my feet the larger portion of the 
time. 

Very gratefully yours, 

Hattie L. Moore. 

William E. Shaw, leg amputated above the knee, for dislocation of 
knee. Artificial leg applied June, 1892. Age nine years. Leg has 
been lengthened twice since then. 

Weber County, Utah, March 11, 1896. 
Mr. A. A. Marks. 

Dear Sir : I received your letter. You wanted to know what success my 
boy has had with his leg. He has had good success with it; he can walk and 
get around very well. He would not be without it for anything. I think 
the best thing that can be done for a child when he has lost one of his limbs, is 
to get an artificial leg without delay. 

Respectfully yours, 

Er/r.TAn Shaw. Jr. 



204 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

John Kershaw, leg amputated above the knee, November, 1890. 
Railroad accident. Artificial leg applied April, 1891, at the age of 
nine years. Leg lengthened March 6, 1895. 

Fall River, Mass., March 22, 1896. 
A. A. Marks. 

Dear Sir : In reply to yours of the 7th would say : I passed John Kershaw 
.on the streets three months ago. From the success attained in his case I shall 
certainly advise the application of an artificial leg to a growing lad as soon as 
his stump is properly healed. 

John Kershaw has been able, thanks to his artificial leg, to enjoy his early 
life equally with others not so unfortunate. 

He plays football, baseball, and all other sports. I think -he would have 
lost all power of his stump if the leg had not been employed, as the stump is 
but about six inches long, and would in all probability have become strongly 
flexed if he had grown older without a leg to keep the joints in condition. 

Yours very truly, 

A. C. Dedrick, M. D. 

Flossie Lee, leg amputated below the knee for injury, in February, 
1891. Artificial leg applied the following August, when the child was 
four years old. 

Chepachet, R. I., March 15, 1896. 
Mr. A. A. Marks. 

Dear Sir : Yours of the 29th ult. received. In reply allow me to say that 
Flossie Lee has worn the artificial leg which you fitted for her five years ago, 
continuously since that time, excepting when sent to you for lengthening. It 
is needless to say that her development in both mind and body is very different 
from what it would have been bad she been confined to the house all these 
years. She has been to school and runs about like other children, which 
means everything to a growing child. No change has been made in the leg 
all these years besides the increase in length. 

Very truly, 

G. A. Harris, M. D. 

Thomas McAieer, leg amputated above knee on account of accident 
in October, 1889. Artificial leg applied at the age of seven years by 
the recommendation of Dr. D. K. Dickinson. 

Chief Surgeon's Office, 

Lead, S. D., March 6, 1896. 
A. A Marks. 

Dear Sir : In reply to yours with reference to the seven-year old boy 
(McAieer), whom you so nicely fitted with an artificial limb, for amputation 
above knee-joint, I will say that it has given perfect satisfaction. I should 
recommend the application of a limb by all means in similar cases. 

Respectfully, 

D. K. Dickinson, M. D. 

Ettie Stangl-, leg amputated below the knee November, 1889. Arti- 
ficial leg applied December, 1890. Age eight years. 

Richardson County, Neb., March 3, 1896. 
A. A. Marks. 

Dear Sir : Your letter of February 28 was received. In regard to the suc- 
cess with that artificial leg, I can say that the leg fits well and Ettie Stangl is 
well pleased with it. She used it a little the evening she received it, and the 
next morning walked three-quarters of a mile to school, and she did not look 
like a cripple. She has moved from here. Speaking for the time she lived here, 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 205 



I can say that the artificial leg was a great relief to her; and I think providing 
her with the limb when she was so young was the best thing to do for her 
health and comfort. 

Yours truly, 

David Jones. 

Mary Wiley, both feet amputated December, 1891. Cause, railroad. 
Artificial feet applied April, 1892. Age eight years. This little girl 
attends school, and is a forcible example of the wisdom of applying 
artificial limbs to children, especially when both legs are amputated. 

Clarence Wintersgill, both legs amputated. Right, six inches below, 
and left, three inches above the knee. Cause, railroad. Artificial legs 
applied September, 1893. Age seven years. 



Beaver County, Pa., March 1, 1896. 
Mr. Marks. 

Dear Sir : In answer to yours of February 27, would say that in my son's 
case the application of a pair of artificial legs has been a wonderful success. 
Clarence was but seven years old when you made him his limbs, and it is won- 
derful how he has learned to use them. He skates, rides his horse, goes to 
school, and can walk several miles without resting. I was advised not to get 
Clarence any limbs till he had ceased growing, and had almost made up my 
mind to wait, but to look at my child sitting out in the yard in the dirt, and to 
think that he must do so until he had finished growing, made me almost frantic. 
In the meantime I received one of your books, and I studied it day and night, 
till I came to the conclusion to try a pair of your limbs, with the results men- 
tioned above. 

You will remember Clarence's left leg is off above the knee, and the right 
below the knee. He was wearing his artificial limbs one year after amputa- 
tion, and if I had to do it over he would wear them in six months. 

Yours with respect, 

R. F. Wintersgill. 

John E. Palmer, leg amputated below the knee, September, 1891. 
Artificial leg applied February 19, 1892. Age nine years. January, 
1894, leg was lengthened. This boy goes to school and occupies him- 
self the same as other boys do. 

Queens County, N. B., Canada, March 7, 1896. 
A. A. Marks. 

Dear Sir : Reply to your request, to know what success my boy has had in 
using his artificial leg, he being only nine years old when he commenced wear- 
ing it ; he is now thirteen. I can say that it has afforded him the greatest ser- 
vice and satisfaction, and he could in no way be induced to do without it ; he 
is growing fast and has the best of health. 

Yours very truly, 

Bradford Palmer. 



Anton Gaub, leg amputated in 1884. Artificial leg applied a few 
months after the amputation. Cause, run over by a wagon. Age four 
years. Gaub is uow seventeen years old, is full grown and well devel- 
oped. He has always used a leg, and never cared to use crutches ; he 
is in good health and very strong, can walk great distances, frequently 
plays baseball, football, and other games. Can skate and dance. His 
parents are in moderate circumstances, his father being a wage-earner. 



206 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

They have never regretted providing their son with an artificial leg. 
Anton Gaub has for some time been employed in a piano factory, 
tuning pianos. He earns supporting wages. 

Roscoe E. Bos worth, leg amputated below the knee April, 1890. 
Cause, railroad. Artificial leg applied February, 1891. Age nine 
years ; leg was lengthened in March, 1893, and the same leg is still in 
use. 

Worcester County, Mass., March 3, 1896. 
A. A. Marks. 

Dear Sir: Yours of the 28th received, and in reply will say I think it 
was a very wise proceeding putting an artificial leg on my son Roscoe, as he 
now has full use of his knee-joint, which I think would not have been the case 
without the artificial limb, and I think he is straighter and in better health. 
It always made him sick with stomach trouble whenever he used crutches. 

Roscoe can skate, ride a bicycle, or do almost anything that other boys do, 
and if I had another child that had the misfortune to lose a ioot at two years 
of age, I should have an artificial limb applied as soon as possible. 

Respectfully yours, 

Levi Bosworth. 

Roy Y. Bryant, leg amputated above the knee in 1890. Cause, run 
over. Artificial leg applied immediately. Age seven. 



Providence, R. I., March 6, 1896. 
A. A. Marks. 

Dear Sir : In reply to yours of February 28, in regard to my son's artificial 
leg, will say my son has worn his artificial leg constantly, with the exception 
of times when it has been at your factory to be lengthened, for over five years. 
He is now twelve years old, and is growing up straight and strong. Of course, 
his height is constantly changing and watch has to be kept so that the leg will 
be kept the proper length. 

You ask whether in my opinion the application of an artificial leg to the 
child before he had become fully grown is a wise proceeding. I will say that 
in this case it was entirely so, as thus far Roy has shown that he has been 
greatly benefited by the artificial leg. ♦ 

Yours very truly, 

E. B. Bryant. 

Willie Bowie, Brooklyn, -N. Y. Leg amputated above the knee in 
March, 1892. Cause, railroad. Artificial leg applied August, 1892. 
Age ten years. 

Brooklyn, N. Y., March 7, 1896. 
Dear Sir : I was hurt when I was ten years old. My father's aim was to 
get an artificial leg for me as soon as possible and he has never regretted it. 

It would be hard for anyone to know that I wear an artificial leg, as I ride a 
bicycle (one day I rode forty-four miles), have learned how to dance fairly 
well, and play all sorts of boys' out-door games. 

I have used one of your artificial legs over three years, and it is gratifying to 
know that one side of my body develops as well as the other. 

Very respectfully, 

Willie E. Bowie. 



Carl T. W. Banks, leg amputated above the knee in March, 1894. 
Cause, railroad. Artificial leg applied September, 1894. Age five 
years. Leg has been lengthened but once. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 207 



Cambridge, Mass., March, 1896. 
Mr. Marks. 

Dear Sir: The question of applying an artificial leg to a young child 
was one of great thought to me, as many of my friends thought it unwise to 
do so. My son, Carl, who was seven years old the 14th of February, 1896, 
has been wearing the leg made by you since September 24, 1894, applying it 
six months after amputation. He plays out doors in all kinds of weather, is 
in perfect health, and is growing .finely ; we have reason to think that the 
leg has been a great benefit to him. It is so much easier to use, and looks so 
much better than crutches. 

Yours sincerely, 

Ellen L. Banks. 

Emma Zern, leg amputated above the knee May, 1891. Caused by 

a stone falling on her leg, crushing it. Artificial leg applied October, 

1892. Age nine years. 

Annville, Pa., March 18, 1896. 
Mr. A. A. Marks. 

Dear Sir : Yours is at hand, asking my opinion in regard to Emma Zern. 
Her leg had been amputated in lower third of thigh in 1890, when nine years 
old. She received an artificial leg which she has used without interruption. 
In the spring of 1895 she had grown 2>£ inches ; the leg was then lengthened 
at a small cost, and she has been using it since. 

At first I was doubtful that a child of her age should have an artificial 
limb, but am now convinced that a child cannot be too young, as this case 
will show. 

Respectfully, 

J. William Trabert, M. D. 

Nellie Cartwright, at the age of eleven, met with an injury in her 
leg that necessitated an amputation below the knee. Sixteen months 




No. 905. 

after amputation an artificial leg was applied. The leg has been 
lengthened twice in three years. A testimonial written in 1896 by her 
father is herewith, appended. Cut No. 905. 

Putnam County, O., March 7, 1896. 
Dear Sir: In reply to yours asking my opiniou as to the advisability of 
applying artificial limbs to growing children, I would say that. I purchased 
from you a leg for my daughter, Nellie Cartwright, in 1893. she being at that 
time between eleven and twelve years old. She lost her foot some mouths 
prior to that time, and, as she has used the leg nearly throe years. I believe I 



208 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



am able to judge of the results, and will say that I would recommend the use 
of artificial limbs for children of any age, and that the sooner a child has a 
leg applied after losing a natural one, the better it Will be for that child. My 
daughter is now fourteen years old, attends school, goes shopping, and enjoys 
out-door exercise as other children do, and one can scarcely tell that she has 
suffered the loss of a foot. I would say in conclusion that in my opinion 
there are two reasons that ought to induce every parent to obtain an artificial 
limb for their amputated child. First : It enables a child to walk naturally, 
and thereby promotes good health and spirits, symmetrical growth and ma- 
turity. Second : A child becomes accustomed to the use of the limb while 
young and active, and will ever afterward use the leg with better results than 
it could if the use was delayed until maturity. 

Respectfully yours, 

J. S. Cartwright, C. E. 



Clara Giere, leg amputated below knee October, 1888. Cause, injury 
from the gearing of a windmill. Artificial leg applied February, 1894. 
Age eight years. 

Bayfield, Minn., March 18, 1896. 
A. A. Marks. 

Dear Sir : Yours of the 29th ult. has been received. The artificial leg 
which I ordered for Clara Giere two years ago, has given good satisfaction. 
The patient has grown some since then, but her father has added to the leg 
from time to time, and she is still using it with much comfort and usefulness. 

Yours respectfully, 

E. Olonzo Giere, M. D. 



Alvin R Eaton, Jr., leg amputated above the knee March, 1891. 
Artificial leg applied May, 1891. Age thirteen. Cause, run over by 
railroad cars. This lad has grown very rapidly, and has had his 
artificial leg lengthened three times. 

Elizabeth, N. J., March 9, 1896. 
A. A. Marks. 

Dear Sir : In reply to your letter of inquiry as to the results of the appli- 
cation of an artificial limb in the case of our son, who was subjected to 
a knee amputation when he was thirteen years old, and had limb applied 
in less than three months after the operation. Our son learned to use 
the artificial limb so readily that he never fully realized the loss of the natural 
member ; his growth was in no way retarded , and it is marvelous to know to 
what athletic feats he is equal. He rides a bicycle, plays tennis and basket 
ball, performing remarkably well on the horizontal bars, has tramped long 
" carries" in the Adirondacks, and shot a deer there the year after his great 
loss, which you so successfully repaired. We are pleased to pay this simple 
tribute to your skill but words fail to express our appreciation of the blessing 
which " The Marks' Artificial Limb " has been for our son. Believe me, 

Most faithfully yours, 

Alvtn R. Eaton, D. D. S. 



Ambrose Mullin, Syracuse, N. Y., both legs amputated below the 
knees April, 1893. Cause, trolley cars. Artificial legs applied March, 
1895. Age four years. Weight, thirty-two pounds. Dr. Gregory 
Doyle, who amputated Mullin's legs, took more than ordinary interest 
in this remarkable case, as his contribution to the Buffalo Medical and 
Surgical Journal of September, 1893, shows : 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



209 



DOUBLE SYNCHRONOUS AMPUTATION OF BOTH LEGS 
IN AN INFANT.— RECOVERY. 

BY GREGORY DOYLE, M. D., SYRACUSE, N. Y. 

On the 8th day of April last, Ambrose Mullin, the infant son of 
Michael Mullin, of 1015 Willis Avenue, Syracuse, N. Y., was run over 
by an electric car, and suffered what was thought at the time fatal 
injuries. Both legs were crushed off just below the knees, and his 




No. 906. 



head was so severely injured as to produce cerebral concussion, large, 
dark tumors being produced on the forehead and occiput. He suf- 
fered also severe contusions over the sternum. About an hour after 
the accident I reached the little patient, and found him in a com- 
plete stupor, and very anaemic from the immense loss of blood. By 
hypodermic stimulation he rallied sufficiently to warrant me in 
removing the mangled members. The amputations were made care- 
fully, but rapidly, as I knew celerity to be a strong element in pos- 
sible success. During the operation hypodermic stimulation was 
persistently kept up, and we had the pleasure of seeing our almost 
hopeless patient slowly but steadily rally from the shock. He made 
a good recovery, without any noteworthy incident. The stumps healed 
rapidly, with good, cushioned ends, so that, hereafter, artificial limbs 
can be worn with comfort, and the child may grow up to be a useful 
and honorable citizen. At present he is able to go about the house 
and yard on his knees, and is healthy and cheerful, as the above pho- 
tograph indicates. 



210 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

The child was born January 10, 1891 ; both legs were amputated April, 
8, 1893; his age at the time of the operation was, therefore, a little 
over two years. As far as I can learn, this is the youngest child on 
record that has recovered from a synchronous amputation of both legs. 

I was ably assisted in this unusual operation by Drs. J. W. Knapp, 
N. L. Mulvey, and Gregory Reidy. 



Syracuse, N. Y., March 1, 1896. 
A. A. Marks, Esq. 

Dear Sir: On the 8th day of April, 1893, Ambrose Mullin was run over 
by a trolley car and both legs were crushed in such a manner that I found 
it necessary to amputate them just below the knees. He made a rapid 
recovery, with well- cushioned stumps. His extreme youth precluded, for a 
time, even the thought of artificial limbs. The little lad was remarkably 
active and vigorous, and would run about the house and yard on his knees, 
which frequently became inflamed from over-use. I feared, as a result, 
permanent ancylosis of the knee-joints at right angles. I finally asked your 
firm if the child could be fitted with artificial limbs that would be practi- 
cable. Your response was encouraging, and I told the father to order them. 
In due time the limbs were properly fitted, and the result has been most 
satisfactory. 

The child wears the limbs every day since he first put them on, and will 
not do without them, as he seems to take a great pride in them. He runs 
about, playing with other children, and few would notice anything unusual in 
his locomotion. 

I am now more strongly than ever impressed with the propriety, and even 
the urgency, of adapting artificial limbs to young children that have suffered 
the loss of one or both legs. 

Ambrose Mullin was but a few days over two years old when his legs were 
amputated. When four years of age he began wearing artificial limbs, and 
has worn them ever since, with complete success and absolute comfort. Had 
he not been protected by artificial limbs, he would have suffered irreparable 
injury to his knee-joints. Where crutches are used at his tender age, the ves- 
sels and nerves of the axillse are so compressed as to interfere with the nutri- 
tion and proper development of the arms. 

Since the child began wearing the limbs, his former irritability and sensi- 
tiveness have left him, and he is now as cheerful as the children he plays with. 

For children that have lost but one leg I would also unhesitatingly recom- 
mend the wearing of an artificial limb, as the development of the child's body 
thereby becomes more symmetrical. 

Sincerely yours, 

Gregory Doyle, M. D. 



Erla Jones was run over by a trolley car when twenty -two months 
old. . Right leg amputated above the knee July 28, 1894. Artificial 
leg applied the following October; weight of the child, twenty-four 
pounds. Leg was lengthened \% inch eleven months after being 
applied. 

Fayette County, Pa. , March 4, 1896. 
A. A. Marks. 

Bear Sir^: Your letter of the 27th ult., with reference to success we have 
had by applying artificial limb on a child so young. I cannot express the 
gratification we feel in having gotten Erla the limb at the earliest possible 
moment after stump was healed. Her leg was amputated on the 31st day of 
August, 1894, and in the latter part of October, same year, she was walking 
alone, with one of your artificial limbs. She has worn it constantly ever 
since, excepting two weeks, when you lengthened it two inches, as she grew 
so fast it became too short for her. She goes up and down stairs alone, and 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 211 



when playing with children you would scarcely know the difference; the 
stump is developing nicely. There can be no question in our case as to the 
wisdom of getting her limb as soon as we did. It has proved a blessing to 
her and to ourselves. 

Respectfully yours, 

J. W. Jones. 



Antone Pojar, August 11, 1893, had his right leg amputated below 
the knee, on account of injury received from a sickle. On the follow- 
ing November an artificial leg was applied. The child was four and 
one-half years old, and weighed forty pounds. Leg was lengthened 
1% inch in September 11, 1895. Of this case Dr. Atkinson writes as 
follows : » 

Dodge, Neb., March 2, 1896. 
A. A. Marks. 

Dear Sir : The artificial limb procured from you in 1893 for Antone Pojar, 
four and one-half years old, has given entire satisfaction. I believe it good 
practice to apply an artificial leg to a growing child, as it allows of a more 
symmetrical development. 

Respectfully yours, 

Ira E. Atkinson, M. D. 

Bertha Reed, Frontier County, Neb. Right leg amputated below the 
knee August 5, 1887. Artificial leg applied October, 1890, when eight 
years old. Weight forty-five pounds. Has worn the leg five years, 
with only one lengthening, except such as were made at home. * 

Abe Reyman, Brooklyn, N. Y. Both legs amputated above the knees 
March, 1894. Run over by trolley cars. Artificial legs applied August, 
1895, at the age of nine years. This lad walks very well, considering 
the gravity of his case. The artificial legs are keeping his hip joints in 
good condition. See illustration and description of this case on p. 119. 
. Charlie Moore, at the age of eight, had his leg crushed by a wagon; 
amputated in 1887 above the knee. Had an artificial leg applied 
within a few months after amputation. The leg was lengthened four 
times in eight years. He is now eighteen years old, good proportions, 
strong, and healthy. 

Sufpern, N. Y., March 4, 1896. 
A. A. Marks. 

Dear Sir : In November, 1885, my little son Charles Moore, then eight years 
old, met with an accident which resulted in the amputation of his right leg. 
He went on crutches two years, but was pale and sickly and grew but little. 
The doctor saying he was afraid constant use of crutches would induce spinal 
disease or lung trouble, I resolved to buy an artificial leg for him. I did 
so, and was delighted with the result. The boy could run, jump, and play 
like other boys from the start. He has grown stout and strong, no one know- 
ing that he is wearing an artificial limb unless they are told. I would advise 
all parents who have children as unfortunate as mine, to buy one of your arti- 
ficial legs without delay, as it certainly is the best means of preserving the 
health and encouraging the growth of the child. Besides the child readily 
adapts itself to the use of one, and learns to handle it much quicker and more 
naturally than a grown person. I advise buying one of the limbs manufac- 
tured by you, because an artificial leg worn by a child, particularly a boy, gets 
very rough usage, as I can testify, and those manufactured by you are admir- 
ably adapted to children's use. They are strong, and at the same time so light 



212 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



in weight. My son wore his for eight years, with only a slight expense occa- 
sionally for lengthening as he grew taller. I was so well pleased with it that 
a year ago, when buying a new one, I ordered from you. 

Very respectfully, 

Mrs. James L. Moore. 



Suffern, N. Y., March 3, 1896. 
Mr. A. A. Marks. 

Dear Sir : In answer to yours of late date, I would say that I am entirely 
satisfied with the leg you made for me. I lost my leg when I was about eight 
years old, and have worn one of your legs for about nine years. At first it was 
quite difficult to handle, as I only had a few inches of my own leg left, and so 
could not control it as well as if I had more stump. I was very small when 1 
lost my leg, and my folks all thought that if I wore a wooden leg it would 
interfere with my growth, but I think that the leg has helped nature in that 
task. It fills the bill. 

Yours very truly, 

Charles C. Moore. 



THE AGED. 

When a persorrhas passed the allotted span of life, and in his declin- 
ing years meets with the loss of a leg or an arm and he recovers from the 
operation and shock, the thought of wearing an artificial limb is at- 
tended with some doubts as to the results attending the venture. Will 
not the infirmities of age come fast and heavy and prevent him from 
using an artificial limb at all ? Is the prospect of living a few years 
promising enough to justify the purchase ? These are questions that 
are deeply considered by persons in moderate circumstances. 

Our experience and research in this line have brought to light a few 
facts that we feel impelled to present to those who are interested in 
this subject. The fact is established beyond dispute that a person of 
any age, no matter how old, who recovers from the shock of having 
an injured or diseased member removed, is destined to live for a num- 
ber of years, and to enjoy good health and renewed vigor. Records 
show that the maimed do not die prematurely, that the removal of a 
leg or an arm has a tendency to lengthen life, adding tone, health, 
and vigor to the system, like cutting a limb from an old tree; the 
demands on the vital forces are lessened, and the remaining parts 
become more abundantly nourished. 

No person can be too old to have an artificial leg applied. Old age 
does not justify the use of crutches or the rolling-chair beyond the 
recuperating period. If an artificial leg will take the place of crutches 
and the invalid chair, the leg should be obtained and applied and the 
crutches discarded. The few years that are left should be made as full 
of comfort and cheer as possible. 

To strengthen our advocacy of the application of artificial legs to the 
aged, we will cite a few of the many cases in which artificial legs have 
been applied, and resulted in being helpful, comforting, and profitable 
to the purchaser. 

Rev. Edward Beecher of Brooklyn, N. Y., brother to the distin- 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 213 

guished divine, Henry Ward Beecher, had his leg crushed by railroad 
cars in 1889, when he was eighty-four years old. Nobody supposed 
that this aged man would recover from the accident or leave the hos- 
pital alive, but by skillful surgery and careful nursing, Mr. Beecher in 
a brief time recovered from the operation and was able to take short 
walks by the use of crutches and the aid of some of the faithful 
members of his family. The writer well remembers when he was sum- 
moned to this clergyman's house. There sat the reverend gentleman, 
his long white hair hanging in wavelets over his broad shoulders. He 
looked weak and tired. He had just returned from a short walk on his 
crutches, and was nearly exhausted. He greeted me with a strong 
voice, somewhat in the following language: "I am a very old man, 
and I don't think I have long to live. It seems foolish for me to think 
of getting an artificial leg, but Mr. Sage of my congregation has been 
very insistent that I should try to walk again, so I have sent for you 
and wish to have you make a leg for me. Mr. Sage told me to get the 
leg, and he would pay the bill. So go ahead and do all you can for me, 
and I will do my best to use the leg." 

The leg was made and applied, and in less than six months after Mr. 
Beecher met with the accident he was walking on an artificial leg. He 
operated cautiously and systematically, and in an incredibly short 
time he became accustomed to the artificial leg, and was able to take 
long walks and to attend to his church and parish work. He found 
the leg easier to operate than the crutches, and much safer, he wore 
the leg for eight years, and frequently walked several miles in a day, 
making a practice of walking a mile every morning. He died at the 
age of ninety-two. 

Let us assume that Mr. Beecher, on account of his advanced age, had 
never applied an artificial leg. Would it be reasonable to suppose that 
he would have lived as long and enjoyed as good health with the little 
exercise the use of crutches would have permitted? The artificial leg 
enabled him to take long walks and more vigorous exercise, and be out 
in the health-giving atmosphere a greater part of the time, and in this 
way contributed to his health and longevity. The denial of an artifi- 
cial leg would certainly have been a severe punishment to this good 
man for the misfortune of having become crippled in old age. 
. Charles Van Brunt, Long Branch, N. J., had his foot amputated on 
account of senile gangrene, when he was seventy years old. An artifi- 
cial leg was applied within six months after the amputation. He used 
that artificial leg for fifteen years; he died at the age of eighty-six. 
During most of the time he performed the duties of janitor in a large 
school. 

George Hinman, New Haven, Conn., had his leg amputated on 
account of senile gangrene, when he was eighty years old. He 
had worn the leg for four years, when he died at the age of eighty- 
four. 

Mrs. Susanna Brown had her leg amputated above the knee at the 
age of seventy-three . An artificial leg was applied four months after 
amputation. She had worn the leg for three years, when she died of 



214 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

pneumonia. Dr. A. L. Brittin, of Athens, 111. , under date of February 
10, 1896, wrote of the case as follows: " Mrs. Susanna Brown of Can- 
trail, 111., for whom you manufactured an artificial leg in 1892, died of 
pneumonia May 1, 1895. The artificial leg was eminently satisfactory 
to her in every way, she being able, when in health, to walk about with 
only the aid of a cane. She was in no sense a helpless cripple. She 
could and did ascend and descend stairs without assistance and without 
fear of falling. Any further information in reference to this interest- 
ing case, I will be pleased to furnish you." 

David Penfield, leg amputated below the knee on account of gan- 
grene, when seventy-two years of age. Dr. White's letter appended 
contains a history of the case. 

Franklin, N. Y., February 6, 1896. 
A. A. Marks. 

Bear Sir : I will gladly give you the facts in regard to David PeDfield's 
case. He was in the seventies when I first saw him, and had had two attacks 
of cerebral apoplexy, which had left one arm and one leg paralyzed to such an 
extent as to make walking and use of the arm impossible. In 1891 I ampu- 
tated the foot of the affected leg for gangrene. He recovered, and in 1892 I 
got an artificial leg from you for him. He learned to use the leg very soon for 
a man of his age and condition, and was able to walk about fully as well as 
before he had gangrene. He lived about a year in comfort and enjoyment, 
when he died. The artificial leg in his case was a pronounced success. 

Yours truly, 

S. J. White, Jr., M. D. 

Nelson Stevenson, Salem, Ind., leg amputated above the knee at the 
age of sixty-seven ; an artificial leg was applied a few months later, 
which was worn for three years, when he died from other causes. 

Frederick Triebold, St. Paul, Minn., leg amputated above knee at 
the age of seventy-four. Artificial leg applied about eight months after 
amputation. Age, at the present time (1896), seventy-six years. 

Cottage Grove, Minn., February 8, 1896. 
A. A. Marks. 

_ Bear Sir : I am pleased to say that Frederick Triebold considers the artifi- 
cial leg you made for him indispensable. His health is remarkably good, and 
he wears the leg all the time. 

Yours truly, 

A. H. Steen, M. D. 

Russell Perkins, leg amputated in 1894 on account of being shot. 
Age sixty -nine. Artificial leg applied eight months after amputation. 

Edmeston, N. Y,, February 6, 1896. 
A. A. Marks. 

_ Bear Sir : Mr. Perkins gets along very well with his artificial leg. He does 
his chores about the farm and frequently comes to town. I saw him at a 
neighbor's funeral. He was not using a cane and was getting along very well. 

Respectfully yours, 

William R. Lough, M. D. 

James R. Bugbee, leg amputated in October, 1892, from injuries re- 
ceived by a fall. Artificial leg applied the following July, at the age 
of seventy-six. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YOEK CITY. 215 



North Attleboro, Mass., February 8, 1896. 
Mr. A. A. Marks. 

Dear Sir : I have used the leg you made for me, two and a half years. It 
has proved generally satisfactory. I am now seventy-nine years old. I am 
able to do my work around the house and garden, which I could not possibly 
do with crutches. 

Yours truly, 

James R. Btjgbee. 

William P. Hiller, Nantucket, Mass., now seventy-four years old, in 
excellent health, a man actively engaged in manual work. He has 
worn an artificial leg for thigh amputation for thirty-one years. 

Nantucket, Mass., February 11, 1896. 
A. A. Marks. 

Bear Sir : I wish to state that I am seventy-four years of age, and have worn 
an artificial leg since 1865. Your artificial legs have proved very satisfactory. 
My stump is very short above the knee. 

Yours respectfully, 

William P. Hiller. 



Bradford Beal, injured by mowing machine. Leg amputated in 1894 
at the age of eighty-three. Leg applied the following February. Read 
his letter. 

HiLLSBORO County, N. H., January, 1896. 
A. A. Marks. 

Dear Sir : The leg you made for me and sent to me a year ago I am wear- 
ing constantly. I can go about the house without any crutch or cane. I 
have gone a mile and back a number of times. I am eighty-four years old. I 
am much pleased with your artificial limb. 

Yours truly, 

Bradford Beal. 

Bartholomew Marks, leg amputated in 1887 on account of railroad 
accident. Artificial leg applied a short time after amputation. He 
still wears the leg, and at this writing (1896) is eighty-one years old. 

Portland, Me., February 11, 1896. 
A. A. Marks. 

Dear Sir : Referring to the artificial leg I got from you some time ago, I 
beg to say that the leg is satisfactory, and is a great help to me. 

Respectfully yours, 

B. Marks. 

Melinda Gillen, Dover, N. J., leg amputated below the knee, March, 

1885, on account of fracture from fall. Artificial leg applied May, 

1886, at the age of seventy-two ; she is now (1896) eighty-three years 
old and wears her leg constantly. 

Dear Sir : 1 take this opportunity of writing to you. I am getting along 
very well for one of my years. All that worries me is that I am afraid that I 
shall live so long that I will have to get another one. I am doing all I can to 
recommend your limbs. 

Yours truly, 

Mrs. Melinda Gillen. 



216 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

James Elliott, Sailors 1 Snug Harbor, Staten Island, N. Y., leg am- 
putated in 1862 ; has worn artificial legs for thirty-four years ; is now 
(1896) eighty-one years old. His health is excellent; he walks a great 
deal and busies himself at times making baskets. 

Rev. Silas M. Rogers, now (1896) seventy-three years old, has worn 
an artificial leg for many years. 

Ellenbtjrg, N. Y., November 21, 1895. 
A. A. Marks. 

Dear Sir : I cannot see how the foot that I have been using now for the third 
year can be in any way improved. It gives me entire satisfaction. I wish you 
the greatest success and prosperity. 

Yours truly, 

Rev. Silas M. Rogers, A. M. 

Henry Allendorf, Cincinnati, O., leg amputated below the knee, 
March, 1892, on account of falling from the roof of a house. Artificial 
leg applied October, 1892, at the age of seventy-six ; now (1896) he is 
eighty years old and wears the leg constantly. We have received the 
following letter regarding this case : 

Cincinnati, 0., February 27, 1896. 
A. A. Marks. 

Dear Sir : I saw Mr. Allendorf to-day. The old gentlemen is doing first 
class. No complaints whatever, and he wishes me to state this fact to you. 
A strange person never notices that he is wearing an artificial limb. 

Very respectfully yours, 

"William Autenreith. 

Mrs. Reuben Ramsdell, leg amputated December, 1891, below the 
knee, on account of necrosis of bone. Artificial leg applied January, 
1894, at the age of seventy-three. The following letter applies to her 
case : 

New Ipswich, N. H., March 2, 1896. 
A. A. Marks. 

Dear Sir : Your letter received. In reply I would state in reference to the 
case of Mrs. Reuben Ramsdell, of East Ridge, N. H., a patient of mine whose 
left leg was amputated in the upper third, on December 3, 1891. 

Mrs. Ramsdell's age at the time of the amputation was seventy-one. -In 
December, 1893, 1 fitted a leg to her of your manufacture. Her stump flexed to 
nearly a right angle, due to contraction of the tendons and muscles, but you 
adapted the leg to this condition admirably. 

Mrs. Ramsdell used the leg with much advantage, and it was a source of 
much pleasure to her until the time of her death, October 25, 1895, at the age 
of seventy-five years, five months, and four days. 

The artificial leg caused her no inconvenience, and afforded her much grati- 
fication, enabling her to lay aside her crutches and use a cane. The immediate 
cause of her death was acute bronchitis. 

Yours truly, 

F. W. Jones, M. D. 



PART II. 
ARTIFICIAL ARMS AND HANDS. 



ARTIFICIAL ARMS. 

Artificial arms that have passed into history are referred to on the 
first pages of this book. The historic arm made for the German 
knight, Goetz von Berlichingen in the sixteenth century, and the arm 
suggested by the celebrated surgeon Ambrose Pare, as well as the 
productions of Le Petit Lorrain, Father Sebastian, Bail 1 iff,. Verduin, 
Serre, Wilson, and De Graef, are described as fully as knowledge will 
justify under the caption "A Bit of History." Unfortunately the 
records of the earlier protheticians are so meager that we are unable to 
ascertain the methods for construction that they employed, and some 
very obscure inferences as to the results attained. We are convinced, 
however, that artificial arms and hands constructed in early times 
were more specific than general in their utility, like the one made for 
the warrior M. Sergius (167 B. a), which was only capable of holding 
a shield to defend his body while in battle. The arm made for a 
celebrated tenor in the sixteenth century was calculated to aid him in 
his histrionic effects, and utterly useless beyond that purpose. 

We are convinced that this art is better understood now than at 
any previous time ; that the arm of the present day is superior in every 
way to the one of the sixteeuth century; that the present range of use- 
fulness is greater, ornamentation more perfect, and the substitution of 
the natural arm carried to a more satisfactory stage. 

The demand for artificial arms has never been as great as it is now. 
The incentive to invent and improve is responsive to necessity, want 
begets supply, and competition is the thoroughfare for improvement. 
The need for prothesis is increasing in direct proportion to the utiliza- 
tion of agricultural, mining, factory, transportation, • and all other 
machinery calculated for the rapid achievement of results. As the mile- 
age of railroads becomes greater, the mutilation of the human body 
becomes more frequent; the mowing machine and the reaper have 
cut off more legs and arms than the scythe or cradle; dynamite 
used in the arts has mutilated the human body and destroyed life and 
limb in far greater numbers than the common black powder of former 
days; the agencies that advance civilization seem to have a baneful 
effect on life and limb. While those agencies are active in doing their 
work of mutilation, prothetic genius is stirred to action. Protheticians 
have improved upon the devices of early masters, and have brought 
the adaptation of artificial arms to more practical and general uses. 
We venture the assertion that as much thought, compared to the rela- 
tive importance, has been given to this subject as to any of the arts 
and sciences, the -sewing machine, the steam engine, and electricity 
not excepted. 

At the beginning of the present year the patent office reported that 

219 



220 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

thirty-five separate patents had been granted for the protection of 
improvements in artificial arms. This represents but a very small 
proportion of the actual number of devices that have been made to 
replace the lost members ; thousands of artificial arms have been made 
that have failed to stand the tests. Fortunes have been wasted in 
trying to produce the Utopian hand, the hand that possesses the 
capabilities of the natural one. 

Most of these devices have been cast aside simply because they were 
useless and burdensome. No person of the present time will tolerate a 
clumsy, heavy, noisy, complicated, and unwieldy arm. Neat adapta- 
tion to the stump, lightness, naturalness of appearance, durability, and 
utility to the reasonable point are the requisites of an acceptable sub- 
stitute, and any device that is devoid of these qualities will not be 
tolerated. 

An artificial arm must necessarily have limited uses, but when 
neatly made, and comfortably adapted, it becomes a valuable and indis- 
pensable companion. The arm conceals the loss, the same as the glass 
eye conceals the withered and visionless eyeball. It protects the stump, 
the same as the wig protects the hairless head. It restores a natural 
appearance to the dismembered side, the same "as an artificial nose 
restores a natural appearance to the face that has been deprived of the 
nasal prominence. It provides a medium that forces the stump into 
healthful activity, and rescues it from that indolence that begets pains, 
throbbings, and distracting sensations. The artificial arm has still 
further functions. It is capable of assisting the opposite hand ; it will 
carry articles of considerable weight. If the stump is sufficiently 
powerful the hand can be controlled by the stump so that it will cut 
meat on the plate and carry the morsels to the mouth. The hand will 
hold a brush that will be convenient in washing the remaining natural 
hand or in brushing the hair. A pen can be placed between the finger 
and thumb, and after a little practice the wearer will learn to write a 
quick and legible hand. A variety of implements can be made, each 
capable of distinct functions. A ring thus applied will help the farmer 
in guiding the handle of a plow, or the handle of any agricultural 
implement; it will help the blacksmith in wielding a sledge. A pair of 
pincers applied to the hand will be capable of holding the work of a 
jeweler; a claw hook, a device, or a hand vise has its valuable 
uses. A vast number of other implements can be attached to the 
hand, as the occupation of the wearer may demand. "While these 
attachments are capable of a large range of adaptation, there is a limit 
beyond which art and science cannot go. X nose operations of the 
natural hand that depend on the brain for their direction and power, 
cannot possibly be performed by the mechanical hand. 

That intelligence with which the natural arm is endowed, is the result 
of the system by which mental force is carried from the brain through 
the nerves, muscles, sinews, and joints to the distant finger. The 
human arm and hand are marvels of mechanism, their combinations of 
motions are limitless, their functions are vast, and their capabilities 
are beyond comprehension. The motion of the shoulder is circum- 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 221 

rotary, the motions of the elbow are flexion and extension, the motions 
of the wrist are rotary, circumrotary, flexion, and extension, and the 
fingers are capable of a range of accommodation that is astounding 
beyond conception. Every joint is connected by powerful tissues, 
sinews, tendons, muscles, nerves, and blood vessels. These perform 
their functions in conveying the commands of the mind to the most 
distant parts, and in compelling an instantaneous obedience. Every- 
thing is harmony — the hand that is capable of placing the delicate 
works of a watch is also capable of laying the stones of a cathedral ; 
the surgeon's hand that can skillfully carry the scalpel is also capable 
of wielding the ax that will fell the monster oak. And yet the human 
arm is but a machine, useless and powerless by itself ; the brain is the 
vis viva that renders it capable of its limitless uses. If the medium 
that conveys the wishes of the mind to the arm be destroyed, if the 
co-ordination be impaired, the arm ceases to be any more valuable than 
the artificial arm, made in the crudest and most unscientific manner. 

An artificial arm, no matter how ingeniously it may be constructed, 
is so remotely comparable with the normal natural arm, that even the 
suggestion of a comparison brings a blush ; but nevertheless that arti- 
ficial arm is more responsive to the demands that may be made upon it 
than the natural arm that has become paralyzed, or so injured that it 
fails to respond to mental forces. 

The natural arm has other endowments aside from its submissive- 
ness to the will. The power of repairing itself is one of its mysterious 
attributes. The bearing surfaces of the bones would grind away and 
wear out were it not for the presence of cushions, lubricating sacks, 
and provisions for replacing the particles that become disengaged by 
work, overstrain, or accident. The tendons would stretch and become 
inactive if the repairing processes were not in constant operation. 
This power of repairing itself is not only present in the bones and 
tendons, but in every component of the arm. If a muscle becomes 
lacerated, or a tendon detached, or a bone broken, the work of repara- 
tion begins, and in a short time the injured part is fully restored. 
Every drop of blood that flows through the arteries carries new mate- 
rial to replace the waste, and every drop of blood that flows through 
the veins carries away the detached, diseased, and worthless particles. 
In old age, when the human repair shop becomes disorganized, the 
entire physical mechanism breaks down, and death soon follows. 

Another great and important endowment of the natural hand, and 
one that is seldom thought of and hardly appreciated, is that of the 
sense of touch. This sense, although inherent, becomes cultivated so 
that the faculty of recognizing objects by the touch becomes acute. 
The contact of the fingers will convey the information (without the 
aid of vision) that the object is soft or hard, that the material is liquid 
or solid, dry or wet. The blind man is enabled to read by the sense of 
touch. Persons who are endowed with normal sight depend largely 
upon this sense. When we place our hands in our pockets, we know by 
this sense whether we take hold of a key or a jack knife, a silver dollar 
or a penny, a handkerchief or a lead pencil. And the moment we touch 



222 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

the object, we know what motions of the fingers are required to put 
that object into our grasp. Persons whose sensory nerves have become 
paralyzed have a sad story of affliction to tell. 

An artificial arm is absolutely^ devoid of sensation. Divinity has 
not privileged the most fruitful mind to endow the products of his 
thoughts with this power. 

When we call to mind the fact that an artificial arm can be made 
with joints, springs, and cords, and that it cannot be endowed with 
mental sympathy, or with the power of repairing itself, or with 
the sensation of touch, we cannot help but become reconciled to the 
fact that it cannot be anything more than a substitute of limited 
capacity. 

We are frequently amused by reading newspaper articles of artificial 
arms, made by forgotten mechanics, ' ' that are fully as good as nat- 
ural arms. 1 ' We frequently have to listen to the narration of some 
magical performances of men who wear artificial arms. We recall 
an article that appeared in a Canadian paper some years ago, of 
a woman who had a pair adjusted to her person, supplementary 
to her natural ones. She became so dexterous in manipulating them 
that when in a public conveyance, she would hold a book in her artifi- 
cial hands, and, while apparently reading, would, with her natural 
hands, pick the pockets of those who sat next to her. 

We have read in the newspaper the story of a politician who lost his 
arm in the Civil War, and who had an ingenious artificial one applied 
that enabled him to shuffle a deck of cards, pick up a glass of beer and 
carry it to his mouth ; and on one occasion, when in a barroom brawl, 
he liberated a spring, and the arm immediately began its pugilistic 
movements, with more vigor and with more deadly results than pos- 
sible for a natural arm, and by this means he emptied a crowded 
barroom. 

We have read a great many newspaper articles equally as absurd as 
the above, and, being acquainted with every method used throughout 
the world for the construction of artificial limbs, we brand all such 
stories as fabrications of poorly informed but highly imaginative 
newspaper correspondents. 

The endeavor of all conscientious manufacturers has been to produce 
artificial arms that possessed the greatest range of utility. A few 
years ago manufacturers were more prone to complicate the structure 
than they are now. The severe lesson of experience has taught the 
older manufacturers that simplicity of construction is the only road to 
satisfactory results. Full finger movements, controlled by intricate 
mechanism, are ideas of the remote past. Limited finger movements 
are conceded to be more desirable and more advantageous. Any man- 
ufacturer of ordinary ingenuity can make a hand that will hold the 
reins of a horse, or that will carry a valise, but to make a hand that 
will assist in the performance of labor and be endowed with the power 
of prehension, delicate enough for some purposes and powerful enough 
for others, is too near the work of Divinity to be within human 
capabilities. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 223 

In the beginning of our endeavors we followed the lines of our com- 
petitors, and made a hand that gave us some pride. By taxing the 
remaining arm, we could force the artificial hand to open, and, by 
relaxing the strain on the connecting strap, it would close. We were 
not long, however, at experimenting on those lines before we became 
convinced of the absolute impracticability of such devices. Our atten- 
tion was turned to the utilization of rubber. The resilient nature of 
that material seemed to us to be more accommodating than harsh, 
unyielding wood or metal. In 1863 the rubber hand was invented illus- 
trated in Cut No. 910. It was attached to the forearm by means of a 
spindle, which admitted of rotation. The fingers were flexible, and 
•would yield under pressure, having sufficient elasticity and adhesion to 
make it accommodating to a degree exceeding those made of wood. 
The hand was natural in appearance and pleasant to the to,uch. It was 




No. 910. 

practically unbreakable; it might fall or strike any hard object, and it 
would not become disordered or impaired. It could be slipped from 
the socket, and a hook, knife, fork, or brush put in its place. For a 
number of years this hand found many purchasers, and was highly 
esteemed, but improvements were suggested from time to time, and the 
rubber hand patented in 1863 passed through a number of stages, until 
it reached its present stage of adaptation. It was a happy thought of 
the inventor — that of changing the fingers from flexibility to ductility. 
The flexible fingers would spring and move under pressure, but as soon 
as that pressure was removed the fingers would return to the positions 
in which they were cast. Ductility gave the fingers the advantage of 
change of positions to accommodate the wearer's wishes. The assist- 
ance of the opposite hand, or the pressing of the artificial hand against 
some resistant body, is all that is necessary to change from flexion to 
full extension — from the clinched to the open hand. The hand, partly 
closed, is capable of carrying a valise or package of considerable weight. 
Cut No. 911 represents the hand partly open. The dotted lines show 
how far the fingers can be flexed and extended. 

An invisible lock is placed in the palm. of the hand, rendering the 
hand capable of holding implements with firmness, thus enhancing 
its usefulnes. 

Cut No. 912 represents the rubber hand with lock imbedded in the 
palm, designed to hold a hook, knife, fork, or brush. When the 
implement is placed in the socket and pressed downwardly, it 
becomes firmly locked. The wearer can press heavily upon any 



224 



A. A. MAEKS, ARTIFICIAL LIMBS, NEW YOEK CITY. 



object or carry any weight that the stump is capable of supporting. 
A fork placed in this lock will enable the wearer to hold food on the 
plate while it is being cut with a knife held in the opposite hand, or 
will convey food to the mouth. A knife placed in the palm lock will 
enable the wearer to cut meat or other articles of food, mash potatoes, 
spread butter, and perform other services. A brush placed in the lock 
can be advantageously used to wash the opposite hand or brush the 
hair. A hook will enable the wearer to carry heavy articles and assist 




No. 911. 

greatly in the performance of labor. When it is desired to remove an 
implement from the hand, a little pressure applied to the button, A, 
will release the hold, and the implement can easily be withdrawn. 

Rubber hands may be attached to forearms by various means. «Cut 
No. 912 shows the spindle method. The spindle is attached to the base 
of the hand and is received into a locking plate which is secured to the 
extremity of the forearm. This locking plate holds the hand firmly, 
and at the same time admits of a slight rotary motion. When it is 




No. 912. 



desired to remove the hand, a little pressure applied to the button, C 
(Cut No. 913), will cause the lock to release its hold and permit the hand 
to be withdrawn. The rotary motion of the hand can be checked at 
any desired point by simply turning the set-screw, B ; thus, if a man 
desires to have the hand set so that it will be either prone or supine, he 
can place the hand in the socket at either of these positions and turn 
the set screw, and it will remain set until the screw is loosened. The 
orifice in the center of the wrist lock is one-half inch in diameter, the 
same as the diameter of the socket of the palm lock. When the hand 
is removed, the wrist catch is capable of receiving any of the imple- 
ments that can be placed in the palm catch ; hence the implements are 
interchangeable, aud can be used in either hand or arm. 



A. A. MAEKS, AKTIFICIAL LIMBS, NEW YOEK CITY. 



225 



Cut No. 913 represents a part of forearm with hand provided with 
wrist spindle; an implement is placed in the palm, showing the direc- 




No. 913. 

tion in which it is held. Cuts Nos. 914, 915, 916, and 917 represent 
ends of forearms with hands removed and implements of various kinds 
inserted. 

The ball and socket method of connecting the hand with the forearm 
is illustrated in Cut No. 918. The end of the forearm terminates in a 




mmm 




' .A.;A ,-rt'/>R'K , S,./yj? 



No. 914. 



No. 915. 



small globe. This is received in the base of the hand, where it is 
held by a clamp, 

A cuff (not shown in the cut) is attached to the base of the hand and 
incases the end of the forearm ; it covers the space at the connection 
of the hand with the forearm. The ball and socket admits of universal 





No. 916. 



No. 917. 



motion, palmar extension and flexion, and lateral extension and 
flexion, rotation and circumrotation. With some persons this com- 
bination is desirable, but with most persons it is worse than useless, as 
so much wrist motion deprives the hand of stability, and makes it 
impossible for the wearer to press heavily on an object. 

Cut No. 918 represents a palmar view of hand with ball and socket 
connection. The cut shows the hand at its extreme right flexion, and 
Cut No. 919 represents the same at its extreme left flexion; the hand is 
capable of assuming any position between those limits. 



226 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



Cuts Nos. 920 aud 921 represent side views of the same, showing the 
range of palmar and dorsal flexion and extension. The hand is pro- 





No. 918. 



No. 919. 



vided with palm lock, rendering it capable of holding implements, as 
before described. The ball and socket mechanism necessitates a round 





No. 9.20. 



No. 921. 



formation of the wrist, instead of the flattened one of nature. Those 
who attach importance to the shape of the artificial arm and hand are 
disposed to object to this, and prefer other hinged methods. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



227 



The mortise and tennon wrist connection admits of flexion and 
extension of the wrist without objectionably increasing the weight of 
the arm or departing from the graceful lines of nature. 

Cut No. 922 represents the mortise and tennon connection. This 
method consists of a series of interlaying strips, held together by 
means of a bolt which forms the axis of motion, and a means for in- 
creasing or decreasing the friction that holds the hand in its various 
positions. The palm is provided with a palm lock, as heretofore 
described, thus rendering it capable of holding any of the implements 
previously referred to. Eotation of the arm is sometimes obtained by 
means of spindle connection introduced immediately above the mortise 




No. 922. 



and tennon joint. This rotation is not always placed in an arm; 
sometimes the length of stump prevents it, other times it is not 
desired. 

We do not advocate the use of any form of wrist connection that 
does not hold the hand to the forearm rigidly, unless utility can be 
sacrificed for ornament. A laboring man would find the instability of 
the hand, due to ball and socket or mortise and tennon connection, a 
hindrance rather than a help, while a society lady would find either 
connection desirable, as by it she will be enabled to place her hand in a 
variety of angles, thus destroying monotony, and adding grace to the 
pose of the artificial member. 

Cut No. 923 represents the mortise and tennon hand flexed, and Cut 
No. 924 represents the same extended. 

Any mechanism employed in holding hands to forearms add more or 
less to the total weight of the structures. It is often the case that 



228 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



society ladies choose to sacrifice the advantages of wrist articulations in 
order to obtain minimum weight. 




Cut No. 925 represents a forearm with hand permanently attached. 
In this method the hand is incapable of articulation at the wrist. 
Rotation is obtained by moving the socket on the stump. This method 
obtains stability, durability, and reduction of weight. 




No. 925. 



The palm is provided with palm lock capable of holding implements, 
as previously described. 



A. A. MAEKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



229 



SPRING THUMBS. 



We have a mechanical device by which the thumb can be made to 
move at its base, away from or toward the fingers. 

Cut No. 926 represents the hand with thumb abducted. This is done 
by contracting the cord passing from the underside of the base of the 
hand upward to the elbow. 

Cut No. 927 represents the hand with thumb pressed against the 
fingers. As soon as the tension on the abductor cord is released, the 
thumb will be forced, by a strong spring, to press against the index and 
middle fingers. When the abductor cord is connected with the artifi- 





No. 926. 



No. 927. 



cial arm above the elbow, the thumb will press against the forefinger 
when the elbow is flexed, and will abduct when the elbow is extended. 

The abducting cord may be carried up the arm and over the back 
and around the opposite shoulder ; it is then operated by a movement 
of the shoulder or a contraction of the chest. 

Considerable mechanism is required in order to obtain spring thumbs ; 
this complicates the construction of the arm and hampers the move- 
ments of the elbow and shoulder. In double amputations, when every- 
thing depends on artificial means, these complications are willingly 
submitted to ; but when there is one natural hand remaining, which is 
endowed with all the functions of nature, the spring thumb becomes 
useless. The natural hand becomes so adept that it performs about all 
the work that was, prior to the amputation, performed by both hands, 
and the artificial hand will not be called upon to perform work that 
will tax the shoulders, elbow, or the natural arm; therefore, a spring- 
thumb hand for a single arm amputation invariably proves valueless. 

With double amputations the conditions are different, dependence 
on artificial hands is absolute, and every motion that can be given is 
a desirable benefit. 

In the above statements we are simply giving the experience of 
thousands who are wearing artificial arms. 



230 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



NATURAL COLOR. 

Artificial hands and parts of hands must be gloved at all times. 
While they may be modeled to natural shapes and have all the grace- 
ful lines, creases, and folds of nature, and while they may be paiuted 
and tinted with artistic nicety, it is not possible to impart to them 
those characteristics that distinguish nature from art. The natural 
hand has a different color in the afternoon to that which it has in the 
morning. When the fingers are extended there are more creases in 
the skin than when they are flexed. When the hand is at labor it is 
broader and the muscles and blood vessels show with more prominence 
than when at repose. An artificial hand cannot possess this metamor- 
phic power; it will thus be seen that the constant use of the glove is 
unavoidable. 



SOCKETS. 

Sockets are made of wood, leather, or aluminum to suit the wishes 
of the purchaser. Makers of experience have almost to a unit set- 
tled upon light and tough wood as the most desirable material. 
Wood is capable of being worked into a more accommodating shape, 
and will retain its shape indefinitely; it is light and, w T hen strengthened 
by rawhide, is sufficiently strong for ordinary purposes; it is also a 
non-conductor of heat. Leather is flexible, and while that may appear 
desirable, it is frequently a source of trouble. A socket that is flexible 
cannot possess sufficient rigidity to be adaptable to many uses. Leather 
absorbs perspiration, becomes foul and offensive to smell, and unless 
extraordinary methods are used to keep it clean, it will become hard 
and dead, and will crack and crumble to pieces. There are occasions, 
however, when leather sockets cannot be avoided. They will be 
spoken of in their order. 



ALUMINUM. 

Aluminum sockets are coming into greater demand, especially when 
applied to long fore-arm stumps. This metal possesses the rigidity of 
copper, and almost the lightness of wood. It has the advantage 
of being waterproof, and for parties who are obliged to plunge their 
arms in water or to work in wet places no better material can be em- 
ployed. A rubber hand permanently attached to an aluminum socket 
will provide a useful, resistant, and durable arm. There are, however, 
two objections to aluminum, one of which is, that it is a metal and a 
conductor of heat and cold. In winter it is cold, in summer it is hot. 
In order to offset this objection, coverings of wool or any other non- 
conductor of heat have to be used. The second objection is that it 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



231 



oxidizes under the chemical action of salt. Persons who perspire 
freely, and whose perspiration is largely charged with salt, must exer- 
cise extreme care to wipe the perspiration from the insides of the 
sockets every time they are removed from the stumps. If perspiration 
is allowed to remain on the walls of the socket it will eat into the metal 
and cause its early destruction. If a sweat-proof lining is placed in 
the inside of the socket, it must be watched closely and replaced 
when worn or when necessity requires. In ordering artificial arms, 
applicants are furnished with sockets according to their wishes. If 
no wish is expressed, sockets are furnished to suit the requirements 
according to the judgment of the maker. 



ARTIFICIAL ARMS FOR SHOULDER- JOINT 
AMPUTATIONS. 



Amputations that are made in the shoulder joints frequently cause 
the absence of integumentary stumps. Sometimes, however, the 
removal of the bone at the shoulder joint is done without the removal 
of the entire arm. A fleshy protuberance forming a stump is per- 




No. 928. 



No. 929. 



mitted to remain. In either case, an artificial arm can be applied 
which will serve the purpose of concealing the loss and restoring a 
natural appearance to the person. 

Cut No. 928 represents an amputation in the shoulder. The entire 
arm is not only removed, but parts of the scapula and clavicle. Cut 



232 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



No. 929 represents an amputation of the arm at the shoulder socket, 
with a very short integumentary stump remaining. 

Cut No. 930 represents an artificial arm calculated for a shoulder- 
joint amputation. The arm is provided with a pad that rests on top of 
the shoulder, which is held in place by means of straps passing around 
the body. It is capable of rotating immediately above the elbow 




No. 930. 



joint. The elbow admits of flexion and extension, which is controlled 
by a flexion strap, one end of which is fastened to the interior of the 
forearm, and the other passes around and under the opposite shoulder. 
A movement of the shoulders will contract this strap and bring the 
forearm to a horizontal position, where it is locked by a mechanical 
device which is concealed in the forearm. The release button to this 
lock is placed on the underside of the forearm, and easily accessible. 
The hand can be attached to the forearm by any of the methods 
referred to in the preceding pages. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



233 



Cut No. 931 represents the arm at flexion, held there by the elbow 
lock. 
Cut No. 932 represents the arm partly flexed. 




Cut No. 930 also represents the arm with brush in the palm, ready to 
be used to wash the opposite hand. Cut No. 931 also represents the arm 




with knife in the palm, and Cut No. 932 with fork in the hand. Cut No. 
933 represents the arm with hand removed at the wrist and a hook 
placed in the end of the forearm. This is the most desirable and 



234 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



useful implement for a laboring man, especially if his arm is ampu- 
tated at the shoulder. 




No. 933. 



Aritficial arms for shoulder amputations are made with strict regard 
to minimum weight, and in order to attain this result the hand is 





No. 934. 



No. 935. 



usually attached permanently to the forearm, and the extension strap 
is dispensed with. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



235 



Cut No. 934 represents a case of malformation. The child was born 
with only one arm. The right side was normally developed, but the 
left was deficient. The scapula turned abruptly upward at its farther 
extremity. This produced a knob on top of the shoulder. It was 
advised by the family physician that an artificial arm would perform 
the valuable service of keeping the body trim and encourage more 
uniform development; accordingly an arm was applied when the 
child was very young. Advantage was taken of the clavicle knob, and 





No. 936. 



No. 937. 



the artificipl member depended largely for its support upon that 
prominence. Cut No. 935 represents the case with arm attached. 
This child became an adept. By a shrug of her shoulder she would 
throw her artificial arm forward, flex the elbow, and control its 
motions in a very natural manner; she grew to a lady of fashion, 
and is now frequently seen in society. She enjoys dancing, she 
flexes the elbow and rests the rubber hand on her partner's shoulder. 
She claims that she has passed many evenings at balls and receptions 
without arousing the slightest suspicion that her left arm was 
artificial. 

Cut No. 936 represents a shoulder-joint amputation of a young girl. 



236 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



An artificial arm, style No. 930, was applied, with most gratifying 
results. 

Cut No. 937 represents a European prince of distinguished lineage. 
When an infant he fell from his nurse's arms, which resulted in his 
right arm becoming paralyzed. As the child grew to manhood the 
paralyzed member maintained its longitudinal growth, but failed to 
develop in size, shape, or usefulness. It was limp and practically the 
same as if dead. While on a visit to America a few years ago, he was 





No. 938. 



No. 939. 



induced by an eminent physician to call on us. We found upon exami- 
nation that the entire right side of the thorax was undeveloped, and 
that an artificial arm could be applied to that side without producing 
a disproportioned figure — an artificial arm constructed on the plan of 
No. 930 ; it was attached outside the withered member. The support- 
ing structure was large" and covered a great area of the shoulder, 
chest, and back. This held the artificial arm in place, as shown 
in Cut No. 938. In dressing, the withered arm was, as always had 
been the custom, permitted to rest close to the body. The clothing 
was placed between the artificial and the withered natural arm, and 
when dressed the prince presented an appearance that was beyond 
criticism, as shown in Cut No. 939 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 237 

Cut No. 940 represents the front view of a subject with No. 930 arm 
applied, and arm flexed. Cut No. 941 represents the back view of the 





.No. 940. 



No. 941. 



same. These cuts show the manner in which the straps support the 
structure. 



238 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



ARTIFICIAL ARMS FOR ABOVE-ELBOW 
AMPUTATIONS. 

Cut No. 942 represents an artificial arm suitable for an amputation 
below the shoulder and above the elbow. Cut No. 943 represents the 
same flexed. The socket and forearm are made of wood. Both are 
excavated, the former to fit the stump and the latter to reduce weight. 
Both are covered with parchment to obtain strength, and are beautifully 



No. 942. 

enameled by a natural-tint preparation. The hand is of rubber, as 
previously described, and capable of being attached to the arm by 
spindle, ball-and-socket, mortise-and-tennon joints, or by being rigidly 
connected. The latter is preferable when minimum weight is an 
object. The arm is capable of being locked at the elbow and, when the 
stump is not too long, it is made to rotate above the elbow. The 
locking attachment is released by pressure applied to the release 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



239 



button found on the underside of the forearm. Suspenders are of 
various kinds, mostly as represented in Cut No. 943. 




No. 943. 



Cuts Nos. 944 and 945 represent above-elbow amputations, to which 
No. 942 artificial arms have been applied. 





No. 944. 



No. 945. 



An arm for amputation above the elbow has some, although limited, 
utility. A hook can be placed in the palm of the hand or in the end of 



240 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



the forearm and the wearer be enabled to carry a valise, a pail, bundle, 
or other weighty object. The arm will keep the stump in a state of 




No. 948. 



activity, and be a source of great comfort and relief. When the stump 
is long and powerful, the elbow can be flexed by a movement of the 
shoulder; and when short, by a shrug of the shoulders. 
The locking attachment in the elbow meets with much favor. The 



A. A. HAEKS, ARTIFICIAL LIMBS, NEW YOEK CITY. 



241 



ability to carry a shawl, a muff, or a purse in the hand while the arm 
is flexed is very desirable. The main purpose, however, is the orna- 
mentation of the body by restoring it to its natural appearance. In this 
respect and that of providing a means that will force the stump into 
healthful activity, it proves a valuable and profitable possession. 

Cuts Nos. 946 and 947 represent artificial arms designed for amputa- 
tions at the elbow joints, or so close that the stumps are of no available 
use. No. 946 style admits the stump from the front, and No. 947 
admits the stump from the back. The upper parts of Nos. 946 and 




No. 949. 



947 are made of leather, formed to accommodate the irregularities of 
the stumps. The forearm of each is made of wood, excavated to reduce 
weight, and covered with rawhide to obtain strength. A locking 
attachment at the elbow holds the arm at right angles when desired. 
The hand can be attached to the forearm by any of the methods 
previously described. Usually the socket is so fitted as to hug the 
smaller parts of the arm above the joint, and thereby obtain sufficient 
security without requiring shoulder suspension. When shoulder sus- 
pension is required, similar devices are employed as those described 
in Fig. 943. 

Cut No. 948 represents No. 947 arm with hand removed and hook 
substituted. This is a very valuable feature for a laboring man. 

Cut No. 949 represents an amputation a little below the elbow joint, 
leaving a stump so short that it cannot be availed of to move the fore- 
arm, thereby necessitating the use of the arm illustrated in Cut No. 947. 



ARTIFICIAL ARMS FOR BELOW ELBOW 
AMPUTATIONS. 

Cut No. 950 represents an artificial arm calculated for a short stump 
below the elbow (less than three inches in length). The hand is made 
of rubber, and provided with any of the means heretofore described 
for connection with the forearm. The socket is made of wood, leather, or 
aluminum, as may be selected; when no choice is expressed we assume 
that a wooden socket is preferred. In any case the socket is made to 
accommodate the stump and possess the likeness of the natural arm, as 
nearly as the conditions will admit; it is covered with rawhide and 
enameled with a water-proof preparation. The part that encases the 



No. 950. 



arm above the elbow is made of flexible leather, the elbow joints are 
of steel, made upon the ginglymoid plan ; they provide for flexion and 
extension. Shoulder straps are applied to assist in supporting the arm 
and to remove the necessity of compressing the biceps uncomfortably. 
It is optional with the wearer whether he shall use the suspenders and 
not compress the biceps, or whether he shall compress the biceps 
tightly enough to hold the arm in place and dispense with the suspend- 
ers. He can change from one plan to the other after the arm is 
obtained. The fingers are sufficiently strong to enable the hand to 

242 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



243 



hold considerable weight. When a hook is placed in the palm, and 
concealed by the fingers, a greatly increased weight can be carried. 

Stumps that are short and flabby require duplex side joints, that 
will allow the upper arm pieces to oscillate. 




No. 951. 



Cut No. 951 represents an arm with duplex joints; the two centers of 
motion admit of a movement in the upper part that accommodates 




No. 952. 



the irregular movement of the elbow joint, and prevents the crowding 

and the folding of the tissues at the front of a short and flabby stump. 

Cut No. 952 represents an arm applied and held at full extension. 



244 



A. A. MAKKS, AETIFICIAL LIMBS, NEW YOEK. CITY. 



Cut No. 953 represents the same, with arm flexed at elbow. A com- 
parison of these two cuts will show that in passing from extension to 
flexion, the elbow has traveled backward and the duplex joints have 
not interfered with its movement. This obviates the crowding of the 
tissues and permits a long range of articulation. 

Duplex joints are only applied to arms for short and flabby stumps. 
They are entirely unnecessary for moderately long ones. It is our 




No. 953. 



desire to simplify the construction of artificial limbs without sacrifice 
of advantage. We, therefore, do not use the duplex joints except 
when conditions actually demand. 

Cut No. 954 represents an artificial arm for a long forearm stump. 
It is constructed essentially the same as No. 950, differing only from that 
in the matter of elbow joints. Leather straps are used instead of steel 
joints; this modification is desirable, as it admits of more freedom 
at the elbow, permitting the artificial arm to extend, flex, and rotate 
with greater facility. A stump must, however, be three or more inches 
in length in order to hold the socket firmly, otherwise leather straps 
will not be effective ; they are durable, do not need oiling, are abso- 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



245 



lutely noiseless, and when worn out can readily be replaced by a local 
harness maker or shoemaker. i 




No. 954. 

Shoulder straps are always applied ; they can be used or discarded at 
the option of the wearer. 





No. 9f>V 



No. 950. 



Cuts No. 955 and 956 represent stumps to which style No. 951 arti- 
ficial arms were applied. The stumps were so short below the elbows 
that duplex joints were required. 



246 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



Cuts No. 957 and 958 represent short forearm stumps that have been 
comfortably accommodated with style No. 950 arms. 





No. 957. 



No. 958. 




No. 959. 




No. 960 



Cuts No. 959, 960, 961, 962, 963, and 964 represent forearm stumps 
of various lengths. Artificial arms constructed on the plan of No. 
954 have been applied to these cases with gratifying results. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 247 




No. 961, 




No. 962. 




No. 963. 



No. 964. 



Price for any of the arms described for amputation below the elbow, 
each $50.00. ■ 



248 



A. A. MARKS, ARTIFICIAL LIMBS, XEW YORK CITY. 



Cut No. 965 represents an artificial arm for a long and strong- stump 
below the elbow. It is not provided with upper arm part, but a leather 
arm belt is connected „with the socket by straps. 






si * ^ 



No. 965. 



This method of attachment is highly satisfactory when the artificial 
arm is not used for carrying heavy articles or performing hard work. 
For light office work, when the stump is well healed and conditions 
favorable, it proves ample and satisfactory. When the strap around 
the arm above the elbow is intolerable, a double strap can be attached 
to the socket and carried up the arm, over and around the opposite 
shoulder. 

Price, complete, $40.00. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



249 



ARMS FOR WRIST-JOINT AMPUTATIONS. 

The amputations of hands at the wrist articulations leave stumps 
that must be put under two separate classes. First, those that are 
tapering, due to the removal of the styloid processes of the ulna and 
radms. Second, those that are flattened and broad at the extremities, 
due to the presence of the styloid processes. . 

FIEST CLASS. 

Out No. 966 represents a stump extending to the wrist. The removal 






No. 966. 



No. 967. 



No. 968. 



of the bony processes has made the extremity smaller than any other 
part. 

Cut No. 967 represents a stump extending to the wrist. In removing 
the styloid process of the radius, that bone became shorter than the ulna. 

Cut No. 968 represents a stump extending to the wrist, with the proc- 
esses removed. It has its smallest dimensions at the extremity. 

Cut No. 969 represents a stump extending to the wrist, with the 
processes removed and the tissues puckered considerably on the under 
side ; the stump consequently a tapering one. 

Cut No. 970 represents a stump extending to the wrist, with the 
processes partly removed, the extremity sensitive, incapable of bearing 
pressure. 

Cut No. 971 represents a wrist- joint amputation, with processes partly 
removed. The styloid process of the ulna is removed obliquely, pro- 
ducing a shortening of the ulna side of the stump. 

Cut No. 972 represents a tapering stump extending to the wrist. 



250 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



Cut No. 973 represents a wrist-joint amputation, with trimmed 
ulna and radius. None of the stumps above described have styloid 
prominences. 



nrrniTniiiiilliiiiiiiiMrrTTTTTTmrse 



No. 970. 





No. 971. 



No. 972. 



^sm^j^^^ 



No. 973. 




Cut No. 974 represents the usual form of artificial arm suitable for 
any of the stumps above described. The arm is constructed with 
leather socket, both above and below the elbow. The forearm socket 
is capable of distension and contraction, by means of which the 
stump can be put in place, and the socket laced so tightly that 
the stump will have uniform bearings. The upper-arm piece is 
regulated by straps and buckles and held at the proper distance from 
the forearm part. It is made to compress the muscle by means of a 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



251 



lacing. The hand is attached permanently to the forearm, as the 
length of the stump prohibits the appropriation of room necessary for 
the introduction of any of the forms of wrist mechanism. If, how- 
ever, the wearer is willing to have the artificial arm an inch longer than 
the natural one in order to remove the hand from the socket, he 
will be so accommodated. The introduction of either the spindle, ball 
and socket, or mortise and tennon connection requires about an inch of 
space, and this must come beyond the extremity of the stump. It is 




No. 974. 



a great convenience to be able to slip the hand from the socket and 
place a hook, knife, fork, or brush in its place. It is also a conveni- 
ence to have the artificial arm the same length as the natural one. It 
remains for the wearer to decide which of the two conveniences he can 
better sacrifice. When the hand is permanently attached, the utility 
of the member is not greatly abridged, as the socket placed in the palm 
of the hand is capable of holding any of the implements heretofore 
described. 

If the wearer objects to leather he can have the socket made of wood 
or aluminum, in either case it will be better to make the socket tubular 
and use side straps, for supports, extending above the elbow. 



252 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



SECOND CLASS. 
Cut No. 975 represents a wrist- joint amputation in which the 
styloid processes were permitted to remain. Cut No. 976 repre- 




No. 975. 



sents a similar stump. Cut No. 977 represents a wrist- joint ampu- 
tation in which the bony processes of the ulna and radius were 
retained, and a large integumentary posterior flap was carried 






No. 976. 



No. 977. 



No. 978. 



over the extremity and sutured laterally across the palmar aspect of 
the stump. Cut No. 978 represents a wrist-joint stump with little or 
no protection upon the extremity. The bony processes of the ulna 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



253 



and radius were permitted to remain. Cut No. 979 represents a wrist- 
joint stump with a flattened extremity, the bony processes retained. 
Cut No. 980 represents a well-protected wrist- joint stump, the bony proc- 
esses present. Cut No. 981 represents a wrist- joint amputation, the 






No. 979. 



No. 980. 



No. 981, 



styloid processes present, but the articulating services of the wrist 
were trimmed, and the end incapable of bearing pressure. Cut 
No. 982 represents a wrist- joint amputation, with the bony processes 
present. Cut No. 983 represents an amputation through the base 






No. 982. 



No. 983. 



No. 984. 



of the hand. Instead of amputating through the articulation, parts 
of the scaphoid and semi-lunar bones were permitted to remain. 
Cut No. 984 represents an ordinary type of wrist-joint amputation, 
and Cut No. 985 represents a wrist-joint stump, with the styloid proc- 
ess of the ulna remaining, but the styloid process of the radius 



254 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



trimmed. Cuts Nos. 986, 987, 988, 989, and 990 represent the 
usual types of wrist-joint stumps, with the bony processes of the 
ulna and radius remaining. 

Cut No. 991 represents an artificial arm, especially designed for 
all stumps of the second class. The socket is made of strong leather, 




No. 985. 





No. 987. 



re-enforced by rawhide. It is formed on a last of accommodating 

shape. The hand is of rubber, with palm lock as heretofore described. 

The styloid processes make the diameters through the ulna and 






No. 988. 



No. 989. 



No. 990. 



radius very large, thus providing means by which the arm can be 
held to the stump without requiring attachments above the elbow 
or over the shoulder. On account of the length of these stumps 
it is deemed advisable to attach the artificial hands permanently to 
the sockets. Rotation can be obtained by the stump, same as when 
the natural hand is present. A full line of implements, a hook, 
fork, knife, and brush, is shown in the cut. The hand is gloved, as it 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



255 



is supposed to be when in use. Cut No. 992 represents the back part 
of the arm and hand. The glove is removed and a fork has been 
placed in the palm. This implement is of great use at the table. It 
will convey morsels of food to the mouth, and will hold meat on the 




No. 991. 

plate while it is being cut. The fork can be removed and a knife 
substituted, which has its own valuable uses. A hook can be placed 
in the hand when it is desired to lift and carry heavy articles, and 



No. 992. 



No. 993. 



No. 994. 



when it is desired to wash the natural hand, a brush can be placed 
in the palm and used to advantage. Cut No. 993 represents the arm 
with hook in the palm, and Cut No. 994 represents the arm with 
brush in the palm. The implements are held with firmness when 
placed in the socket, and enable the wearer to perform an unlimited 
variety of work. When the styloid processes will not submit to pres- 
sure, and the subject cannot depend on the lacing socket for security, 
it is advisable to connect the upper part of the socket with suspenders 
that can be carried above the elbow or around the shoulders. This 
attachment will hold the arm very securely in place and is desirable 
when tbe arm is to be worn by a person who is required to occasion- 
ally lift or pull with the artificial arm. If the wearer's habits are 
sedentary, the suspender is not needed and should be discarded. A sock 
should always be worn on the stump for protection and cleanliness. 
Price $30.00 each. 



256 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



ARTIFICIAL ARMS FOR DOUBLE AMPUTATIONS. 



A person who has been deprived of both arms presents the strongest 
plea to the artificial arm maker. If both arms are amputated above 
the elbows his condition is the most deplorable. He is neither able to 
feed himself, prepare his food, dress himself, nor attend to the demands 
of nature. Something must be done to ameliorate his condition, 
otherwise he is forced into habits that are revolting, or he remains a 
helpless dependent upon others. Anything that will help him out of 
this condition, no matter how little, will be a benefit, and should be 
done without hesitation. 



^^ 





No. 995. 



No. 996. 



Cut No. 995 represents a young man who had both of his arms crushed 
by a railroad accident, which resulted in amputations above the elbows. 
Cut No. 996 represents the same person with a pair of artificial arms ap- 
plied ; as may be surmised, the arms were of very limited use, but not- 
withstanding that fact they mitigated his affliction to a considerable 
degree. By a shrug of the right shoulder he was able to bring the 
artificial forearm to right angles, in which position it would remain ; 
this provided a means by which articles could be laid on his forearm 
and carried. His left arm could be flexed by means of the stump, 
which was long and powerful ; when at extension a pail or basket could 
be carried in the hand, and many services could be performed. The 



A. A. MAEKS, AETIFICIAL LIMBS, NEW YOEK CITY. 



257 



arms contributed to the young man's comfort, and rescued him from a 
life of absolute idleness. 
Cut No. 997 represents a case of the right arm amputated above the 




No. 997. 

wrist and the left above the elbow. Cut No. 998 represents a pair of 
artificial arms applied. The right arm was under control of the natu- 





No. 998. No. 999. 

ral elbow and able to flex and extend, the hand was capable of holding 
a variety of articles, and by the use of implements placed in the palm, 
the young man was capable of performing considerable work. The 



258 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



left arm could be flexed and extended at the elbow, by means of an 
extension strap passing over the shoulders ; a hook in the left arm was 
frequently used instead of the hand. 

Cuts Nos. 999 and 1000 represent cases of double-arm amputations 
somewhat similar to those described. Artificial arms have proved to 
be indispensable in both cases. 

Cut No. 1001 represents an artificial arm constructed on the plan of 
No. 942 applied to a right side, and an artificial arm constructed 




No. 1000. 

on the plan of No. 965 to a left side. Both hands were provided with 
spring thumbs, which were operated by the contraction of the thumb 
cords, thus enabling the wearer to remove his hat from his head, pick 
up articles and hold them with firmness. 

By the aid of artificial arms this man became capable of providing 
for his own support. Without them he would continue to be a 
burden to his family. To avoid any misunderstanding, we repeat the 
fact that while artificial arms proved to be helpf ul and invaluable to 
this person, his disabilities were but partially removed. 

Cut No. 1002 represents a double amputation below the elbows. 



A. A. MARK'S, ARTIFICIAL LIMBS, NEW YORK CITY. 



259 



Artificial arms applied to amputations below the elbows are far 
more useful than those applied to amputations above the elbows. 




No. 1001. 

Natural elbow joints are of great value in the management of the 
attached arms. 




No. 1002. 



Cut No. 1003 represents a double amputation of forearms. Both 
stumps long, extending nearly to the wrists. Cut No. 1004 represents 
a pair of artificial arms applied. The wearer was enabled to prepare 



260 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



his food at the table, convey it to his mouth, perform labor of a great 
variety, carry articles of considerable weight, write a legible letter, 
open and close the door, and could attend to the adjustment of his own 
attire to a considerable extent. 
The use of spring thumbs is always desirable in double-arm ampu- 





Nb. 1003. 



No. 1004. 



tations, and unless otherwise instructed we assume that the wearer 
desires to have them introduced in the hands he is ordering. 

It is neither necessary nor desirable to apply spring thumbs to arms 
for single amputations, for reasons that have been given under the cap- 
tion " Spring Thumbs." 

Cut No. 1005 is one of the living evidences of the severity of the 
blizzard of Atarch, 1887. This man was attending to his duties in the 
railroad service when the unexpected storm came upon him, and before 
he could find shelter both feet and both hands were frozen. He 
was discovered in an almost lifeless condition 4 and taken to a 
hospital. It was found necessary to amputate the right hand 
through the metacarpals, the left hand near its base, the great toe 
of the right foot, and the left foot a little above the ankle. Cut No. 
1006 represents a pair of artificial hands and one artificial leg applied. 
Each hand was made with moving thumbs, which were connected 
with levers that were operated by the forearm. When the stumps 
were flexed the levers would force the thumbs to close with consider- 
able power ; when the stumps were extended the force applied to the 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



261 



levers was reversed and the thumbs were caused to abduct. A 
leg was applied to the left lower extremity, and by these appliances 




No. 1005. 





No. 1006. 



No. 1007. 



this person was enabled to walk acceptably and labor and earn his own 
livelihood. Cut No. 1007 represents him as he appears in daily life. 



262 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



PARTIAL HAND AMPUTATIONS. 

Amputations that have been made in the palms of the hands or 
through the fingers are capable of prothetic treatment, that not only 
restores natural appearances to the mutilated members, but enhances 
the utility of the remaining parts to a considerable degree. If a large 
part of the hand has been removed, the artificial part will prove of 
greater value than if but a small part is removed. If the fingers are 
amputated and the thumb remains, artificial fingers will provide a 
medium against which the thumb can be pressed, thus restoring in a 
measure the valuable grasping power of the hand. When only a part 
of a finger is amputated, it is not regarded as important that an arti- 






No. 1008. 



No. 1009. 



No. 1010. 



ficial part should be applied ; it can be of but little service, aside from 
that of concealing the loss and giving the hand a natural appearance 
when covered by a glove. The exceptions are cases where the entirety 
of the fingers are necessary to perform the work in which the subject is 
engaged. For example, pianists, organists, and musical instrument 
players generally. We were called upon some years ago to furnish 
the half of the middle finger to a flute player. He found it necessary 
that the deficient member should be restored in its length, so that he 
might place that finger on the frets of his instrument. The finger was 
made accordingly and served satisfactorily. The stumps must be long 
and powerful in order to hold and control the attached parts firmly 
enough to meet the wants of professional persons. 

Cut No. 1008 represents a hand that has been amputated at the bases 
of the fingers and thumb. But the stumps that were left were too 
short to be available in controlling individual fingers. Therefore, it 
was found necessary to attach a rubber hand similar in construction 
to that represented in Fig. No. 1047. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



263 



Cut No. 1009 represents a partial hand amputation. The fingers 
were removed at their bases, and the thumb removed below the first 
joint. 




No. 1011. 




No. 1014. 




No. 1017. 



0tfli^ 




No. 1012. 




No. 1015. 




No. 1018. 




No. 1013. 




No. 1016. 




No. 1019. 



Cut No. 1010 represents a stump with the fingers and thumb re- 
moved through the metacarpals. 

Cut No. 1011 represents a partial hand amputation, and Cuts Nos. 
1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 
1024, 1025, and 1026 represent partial hand amputations, presenting 
many peculiarities. Some stumps have fingers remaining, others 



264 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



have not. Style No. 1047 hand was applied to each and every one of 
these cases. 

Cut No. 1027 represents a partial hand amputation. All the fingers 
were removed at their bases, the thumb remaining unimpaired. 

Cut No. 1028 represents a partial hand amputation, all of the fingers 





No. 1020. 



No. 1021. 




mm 




No. 1023. 





=^f 




No. 1024. 



No. 1025. 



No. 1026. 



removed obliquely through the metacarpals, the thumb remaining un- 
impaired. 

Cut No. 1029 represents a partial hand amputation, all the fingers 
removed and most of the metacarpals ; the thumb remained, but on 
account of the destruction of the adductor muscles the thumb became 
abducted and required support. 

Cuts No. 1030, 1031, 1032, and 1033, represent partial hand amputa- 
tions, the fingers removed obliquely through the metacarpals, thumbs 
remaining. 



A. A. MAEKS, ARTIFICIAL LIMBS, NEW YOEK CITY. 



265 



Cut No. 1034 represents a partial hand amputation; the fingers 
removed at their bases, and the thumb partly removed at the base of 
the nail. 






No. 1027. 



.No. 1028. 



No. 1029. 




No. 1030. 



No. 1033. 




No. 1031. 




No. 1034. 




No. 1032. 




No. 1035. 



Cut No. 1035 represents a partial hand amputation; the fingers 
removed and part of the palm. All of the above hands were supplied 
with artificial parts constructed upon the plan of No. 1018. 



266 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



Cut No. 1036 represents a partial hand amputation, the index and 
small fingers were removed a little below the second joints, the two 
middle fingers were removed at the bases. The artificial hand that was 
applied to this case was constructed upon the plan of No. 1048, with 
the index and small fingers made large at their bases and connected 
with the rest of the hand. 






No. 1036. 



No. 1037. 



No. 1038. 






No. 1039. 



No. 1040. 



No. 1041. 



Cuts Nos. 1037 and 1038 represent the amputations of the index fin- 
gers near their bases. Artificial fingers constructed on the plan of No. 
1050 were applied. 

Cut No. 1039 represents an amputation of the index, middle, and 
ring fingers; the thumb and small finger were injured and became 
motionless. A hand constructed on the plan of No. 1052 was applied 
to this case. 

Cut No. 1040 represents the amputation of the thumb and three fin- 
gers, the small finger remaining unimpaired. An artificial hand, con- 
structed somewhat on the plan of No. 1051, with rubber thumb attached, 
was applied to this case. 

Cut No. 1041 represents a similar case and treated the same. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



267 



Cut No. 1042 represents an amputation of the index finger through 
the first phalanx. A finger constructed on the plan of No. 1050, with 
a leather socket extending well down on the hand, was applied. 

Cut No. 1043 represents a mutilated hand; the thumb crooked and 
more or less impaired, the index finger removed at the first joint, the 






No. 1042. 



No. 1043. 



No. 1044. 





No. 1045. 



No. 1046. 



rest of the fingers removed, together with a part of the palm. A 
suitable hand was made and applied. 

Cut No. 1044 represents a hand mutilation; the thumb abbreviated, 
index finger injured so that it became flexed and rigid at the first" joint. 
Artificial hand suitable for the case was made and applied. 

Cuts Nos. 1045 and 1046 represent the amputations of thumbs. 

Cut No. 1049 represents a style of thumb made and applied to each 
case. 

Cut No. 1047 represents a rubber hand, modeled to fit the stump 
and to match as near as possible the remaining hand. It is composed 
of rubber, with ductile or rigid fingers, as may be chosen. It is pro- 
vided with a lacing running down the palmar line. The stump is in- 
serted in the hand, and laced about the wrist. 



268 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



Cut No. 1048 represents a hand similar to No. 1047, but provided 
with an aperture through which the remaining thumb is allowed to 
pass. In other respects it is constructed and attached to the hand in 
the same manner as No. 1047. 

Cut No. 1049 represents an artificial thumb, made of either rubber or 





No. 1047. 



No. 1048. 



aluminum. It is of convenient shape to slip over the stump or 
attach to the hand. 

Cut No. 1050 represents an artificial finger made of rubber or alum- 
inum, as may be chosen. It is hollow, so as to slip upon the stump, or 





No. 1049. 



No. 1050. 



is made with continuous base, so as to pass upon the back and front of 
the hand, and lace in place. 

Cut No. 1051 represents a rubber hand, calculated to be placed upon 
a hand from which the index and small fingers have been removed. 

Cut No. 1052 represents a rubber hand to accommodate a case in 
which the index, middle, and ring fingers have been removed. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



269 



Cut No. 1053 represents a rubber hand to accommodate an amputa- 
tion of the index and ring fingers. These hands are made in the same 
manner as No. 1047. The apertures are to permit the remaining fingers 
of the mutilated hand to pass through. Artificial hands and parts of 
hands are made of rubber or aluminum, as may be selected by the 
wearer. Rubber is generally preferred, as it is pliable, more comfort- 
able to wear, and possesses a large range of usefulness. The fingers are 






No. 1051. 



No. 1052. 



No. 1053. 



flexible, soft, ductile, or rigid, according to the wishes of the wearer. 
Aluminum, is durable and light, and retains its shape a great length 
of time. The angles at which the fingers are placed are to be those 
that are the most accommodating for the wearers ; they should be de- 
termined before the orders are placed. 

As rubber or aluminum fingers have to be modeled to order and cast 
in molds especially prepared, they are expensive to produce. The 
making of model, mold, and one hand for any of the above hand am- 
putations, will cost $50. If duplicates are wanted at any future time, 
they can be furnished at $20 each, provided the original model and 
mold require no change. The cost of a single finger or thumb, either 
rubber or aluminum, is $30. Duplicates can be had at $10 each, if 
original models are acceptable. Plaster casts of the mutilated member, 
as well as diagrams and measurements of the companion or sound 
hand, are required to fill each order. 



270 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



DEFORMITIES, APPARATUS FOR RESECTIONS, ETC. 

There is a class of deformities and resections of upper extremities 
that can be treated prothetically, as they require artificial parts the 
same as amputations. Hands and parts of hands are made to attach to 
the malformed members, so as to correct the deformities and supply the 
deficiencies so far as to make those members useful and ornamental. 
A number of deformed hands and arms have been illustrated and 
described in preceding pages. 





No. 1054. 



No. 1055. 



Cut No. 1054 represents a deformity of forearm, the elbow joint pos- 
sessing normal conditions, flexion, and extension full and powerful, 
the end of the stump terminating in a knob protruding from one 
side. 

Cut No. 1055 represents a deformity of elbow joint and forearm. A 
very slight movement remained in the elbow, the forearm terminating 
in an enlargement. Both of these deformities w T ere treated the same as 
wrist-joint amputations, and artificial arms were applied that encased 
the forearms and took support from the enlargements on the extremities. 
An artificial arm constructed on the plan of No. 991 was applied 
to each case, with gratifying results. 

Cut No. 1056 represents a deformed hand, the metacarpal section 
greatly abbreviated and the fingers rudimentary, wrist mobility 
almost imperceptible. This case was treated the same as a hand ampu- 
tation, and an artificial hand constructed upon the plan of No. 1047 
was applied. 

Cut No. 1057 represents a deformity of the hand. The metacarpals 
appear to be normal, all but one finger absent. The case was treated 
the same as an amputation, and a hand similar to No. 1047 was applied. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



271 



Cut No. 1058 represents a deformity of the hand, metacarpals very- 
small, fingers rudimentary, one finger corresponding to a thumb 
remaining. The case was treated the same as a partial hand amputa- 
tion, and a hand constructed on the plan of No. 1048 was applied. 

Cut No. 1059 represents a deformity, the thumb and small finger 






No. 1056. 



No. 1057. 



No. 1058. 



% \. \ 






No. 1059. 



No. 1060. 



No. 1061. 



present, but greatly distorted and valueless. A hand constructed on 
the plan of No. 1047 was applied. 

Cut No. 1060 represents a deformity, the hand rudimentary, and the 
fingers webbed and nearly closed, wrist without motion. The case was 
treated the same as an amputation, and a hand constructed upon the 
plan of No. 1047 was applied. 

Cut No. 1061 represents a hand deformity, metacarpals undeveloped, 
with rudimentary fingers, which were contracted and valueless, the 
wrist normal. The case was regarded the same as an amputation, and 
a hand constructed upon the plan of No. 1047 was applied. 



272 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



Cut No. 1062 represents a hand deformity, metacarpals perfect, and 
fingers rudimentary. A rubber hand constructed upon the plan of No. 
1047 was applied successfully. 

Cut No. 1063 represents a deformity, metacarpals imperfect, thumb 
and index finger partially developed, other fingers rudimentary. A 
rubber hand was modeled for this case, with thumb detached from the 
hand and made to slip on the stump separately from the fingers. The 






No. 1062. 



No. 1063. 



No. 1064. 






No. 1065. 



No. 1066. 



No. 1067. 



No. 1068. 



fingers were combined with one socket which encased the metacarpal 
region. 

Cut No. 1064 represents a hand deformity, the thumb and three fingers 
absent, the little finger present, which possessed insufficient strength 
to be available; it was pressed against the hand, and treated as an am- 
putation. No. 1047 rubber hand was applied. 

Cut No. 1065 represents a deformity, the hand terminating with 
thumb possessing normal conditions. An artificial hand was modeled 
and applied to this case ; it supplied the missing fingers and permitted 
the natural thumb to protrude from the socket. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 2*73 

Cut No. 1066 represents a deformity of the hand, thumb and fingers 
undeveloped. The artificial part supplied, consisted of three fingers to 
take the place of those that were absent, and a thumb that was attached 
independently. 

Cut No. 1067 represents a malformation, fingers and thumb rudi- 
mentary. An artificial hand with a full complement of fingers was 
made that encased the entire hand, which restored a natural appear- 
ance to the deformed member. 

Cut No. 1068 represents a deformed hand, the fingers and thumb 
rudimentary. The case was regarded the same as an amputation, and 
a hand constructed with thumb and fingers modeled to as near the 
natural lines as possible, with index and middle fingers webbed at feheir 
bases, was applied. 



274 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



APPARATUSES. 



In cases of ununited fractures of the humerus or of the ulna and 
radius, apparatuses must be applied that will hold the ununited bones 
in their proper positions, and at the same time give the arm sufficient 
rigidity to enable the hand to lift and carry articles and perform labor. 

Dislocated shoulder or elbow joints, and exsections of elbow joints, 
must be treated in a similar manner. 

Cut No. 1069 represents an apparatus for ununited fractures of either 
humerus or radius and ulna ; the forearm and muscle parts are con- 





No. 1069. 



No. 1070. 



structed of materials sufficiently rigid to serve the purpose. They are 
connected by articulating joints that work in harmony with the elbow, 
the parts being laced sufficiently firm to hold the bones in place and 
give the arm strength and firmness. 

Cut No. 1070 represents an apparatus for exsection of the elbow 
joint, or for the proper support of a weakened shoulder joint. The 




No. 1071. 



forearm and muscle parts are made of suitable material and are con- 
nected by joints that work in harmony with the elbow. The muscle 
part is terminated by a hood fitted to the shoulder, and made to rest 
comfortably upon it. When necessary, a strap connected with the 
hood is passed around the body, which holds the appliance firmly in 
place. 
Cut No. 1071 represents a partial hand amputation. The subject was 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 275 

a sailor, and desired an appliance that would enable him to hold a rope 
or carry articles of considerable weight. 

Cut No. 1072 represents a socket and hook made to accommodate his 
wants; the socket was made of leather, formed to fit his mutilated 
hand, with apertures to admit the passage of the little finger and the 
remaining part of the thumb. Between the two apertures a strong 





No. 1072. No. 1073. 

hook of flattened steel was secured. With this appliance attached as 
shown in Cut No. 1073, the usefulness of the mutilated hand was 
greatly enhanced. 

Our experience in devising appliances for deformed, mutilated, dis- 
torted, and injured hands, has been extensive, and we feel competent 
to do much for those who are in need. "We will at any time gladly 
counsel any person thus afflicted, and will always give advice without 
charge, and will construct the most useful appliances at moderate 
charges. 



RUBBER HANDS APPLIED TO ARTIFICIAL ARMS OF 
OTHER CONSTRUCTION THAN OUR OWN. 

We have devised methods by which we can attach rubber hands to 
artificial arms no matter upon what plans they may have been con- 
structed. We charge $20 for each hand ; this includes a full line of im- 
plements, namely, hook, knife, fork, brush, and a pair of kid gloves. 



276 



MAEKS, ARTIFICIAL LIMBS, NEW YOEK CITY. 



PEG ARMS. 



There are artificial arm- wearers who do not care to combine the 
ornamental with the useful ; they are willing to sacrifice every embel- 
lishment in order to curtail expense. They are willing to use a hook 
attached to the arm, and dispense with the hand. The demands upon 
their resources are already so great that they find it necessary to sacri- 
fice ornament from the standpoint of economy. Peg arms are made 
to accommodate those persons. An arm for an amputation at the 




No. 1074. 

shoulder or above the elbow, can be essentially the same in construc- 
tion as No. 930 or No. 942, but by being constructed with elbow joint 
and without a hand, its cost will be but little less than one with a 
rubber hand. 

Cut No. 1074 represents an arm for an amputation above the elbow. 
It is provided with elbow motion, elbow lock, wrist plate, but no hand. 
A hook is slipped in the extremity, which enables the wearer to carry 
articles and perform a variety of work. The price of this arm, with 
a full complement of implements (except hand) is $65. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



277 



Cut No. 1075 represents an arm for an amputation above the elbow, 
constructed of wood, without elbow motion, and terminating in a hook. 
It is made in a partly flexed position at elbow for convenience, but can 
be made straight or curved to any angle that may be desired. For a 
laboring man the angle shown in the cut is considered the most accom- 
modating. It is held firmly- to the stump by means of a shoulder 
strap. This arm is very useful for a laboring man who has a very 
short stump, and will enable him to carry articles, lift, pull, and pry. 





No. 1075. 



No. 1076. 



Cost from $30 to $40, according to finish. A full set of implements, 
namely, hook, knife, fork, and brush, is included in the above price. 

Cut No. 1076 represents a peg arm for elbow-joint amputation. There 
is no motion at the elbow, no hand at the wrist. The arm is partly 
flexed at the elbow, as shown in cut. The stump is received from 
the front and laced securely in place. Price $30 to $10, according to 
finish. 

Cut No. 1077 represents an arm for an amputation below the elbow. 
It is constructed essentially the same as style No. 951— without a 
hand. Cut No. 1078 represents same with hook placed in forearm; 
knife, fork, or brush can in the same manner be placed in the end. 
Price $40, with a full line of implements. 



278 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITT. 



Cut No. 1079 represents an arm for an amputation below the elbow, 
without attachments above elbow. The arm may be constructed of 




No. 1078. 



No. 1079. 



wood, leather, or aluminum. Price $25 or $30, according to finish, 
with a full supply of implements, and also with suspender or upper- 
arm strap, as may be selected. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



279 



SUSPENDERS FOR ARTIFICIAL ARMS. 

Cut No. 1080 represents a suspender for artificial arm, usually for 
amputation below the elbow. It consists of a shoulder plate, which is 
made of leather, calculated to cover the shoulder from the base of the 
neck to nearly the point of the shoulder. A webbing strap is at- 
tached at one end to the back of the shoulder plate, and the other is 
buckled to the front; this strap passes around the body, under the 
opposite arm. Leather straps are attached to the lower edge, both 





No. 1080. 



No. 1081. 



front and back, which are connected with the upper part of the arti- 
ficial arm. Price, each, $2. 

Cut No. 1081 represents a suspender for an artificial arm for ampu- 
tation above the elbow. The plate consists of a piece of strong 
leather, formed to fit the shoulder, one edge is brought close to the 
base of the neck, and the other above and near to the point of the 
shoulder. A webbing strap attached to the back of this plate passes 
around the body under the opposite arm, connecting with the front 
of the shoulder plate and adjusted by a buckle. The lower edge of 
the shoulder plate is provided with a row of eyelet holes for lacing, 
by which the upper part of the artificial arm is secured. Price, 
each, $2. 



280 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



IMPLEMENTS. 

Implements for artificial arms are of an endless variety, hooks, knives, 
forks, brushes, clevises, claw-hooks, pinchers, clamps, and rings. 
These are but few of the many devices that have been made for per- 
sons whose occupations demand something aside from the usual 
line. Each arm is supplied with a hook, knife, fork, and brush. 
These are included in the costs, and are always furnished. When 
additional implements are desired, they are furnished at the prices 
named below, and if a customer desires an implement made to order 



No. 1082. 



No. 1083. 



for any special purpose, we will gladly make it for him. Our charges 
for the same will be moderate. 

Cut No. 1082 represents a knife calculated to be carried in the palm 
of the hand or in the end of the forearm. The blade is made of steel, 
the handle of hard rubber. The cut represents it one-half its length. 
Price, each, 50 cents. 

Cut No. 1083 represents a fork calculated to be carried in the palm 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



281 



of the hand or in the end of the forearm, The illustration is one-half 
size. Price, each, 50 cents. 

Cut No. 1084 represents a brush calculated to be carried in the palm 
of the hand or in the end of the forearm. This brush is a great assist - 





No. 1085. 



No. 1086. 





No. 1087. 



No. 1088. 



ance in washing the opposite hand. The illustration is one-half size. 
Price, each, $1. 

Cuts Nos. 1085 and 1086 represent hooks calculated to be carried in 
the palm of the hand or in the end of the forearm. They are made 
with straight backs, so that they can be received in the palm of the 
hand ; made in two sizes. The illustrations are one-half size. Price, 
each, $1. 

Cut No. 1087 represents a round hook, calculated to be used in the 
end of the forearm. . The curved back prevents the hook from being 



282 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



placed in the palm of the hand. The illustration is one-half size. 
Price, each, $1. 
Cut No. 1088 represents a claw hook, calculated to be worn in the 





No. 1089. 



No. 1090. 




No. 1091. 




No. 1092. 



end of the forearm. One part is made with two prongs, and the 
other with one ; it is capable of being opened, closed, and set. This 
device enables a mechanic to clasp a tool with great firmness. The 
illustration is one-half size. Price, each, $5. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



283 



Cut No. 1089 represents a ring capable of being used in the end 
of the forearm. It can be immovably attached to the spindle, or 
allowed to swivel. The ring is serviceable for mechanics and farmers. 
Through it, the handle of a tool or farming implement can slide' while 
the tool is held firmly and directed by the opposite hand. Illustration 
is one-half size. Price, each, $2. 

Cut No. 1090 represents a clevis, calculated to be used for holding shop 
or farming implements. A quarter inch hole must first be driven through 
the handle at the proper place, then the pivot pin unscrewed from the 
clevis, the clevis must then be placed over the handle, and the pivot 
pin passed through one fork of the clevis through the hole in the 
handle and screwed into the other fork. This will hold the tool in an 
accommodating way and permit it to swivel. Illustration is one- 
half size. Price, each, $3. 

Cut No. No. 1091 represents pinchers calculated to be used in the end 
of a forearm. The jaws can be opened and closed by means of a string 
connected with the shoulder. When the arm is extended, the con- 
tracting cord will act on the handle of the pinchers and cause the jaws 
to open. When the arm is bent the force on the contracting cord is 
released, the spring under the pinchers' handles acts, and the jaws are 
forced to close and hold whatever may be placed between them. Illus- 
tration is one-half size. Price, each, $8. 

Cut No. 1092 represents a combination pinchers and hook. Price, 
each, $9. 

UTILITY. 

The services capable of being performed by artificial arms, especially 
when applied to forearm stumps, are almost limitless. Ambition and 




No. 1093. 

practice extend the scope of usefulness. We have a young lady patron, 
an amanuensis, who uses her rubber hand for holding and guiding a 



284 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



pen while writing. She has acquired the ability of writing quickly and 
legibly, and wields the pen with more dexterity than many writers who 
have natural hands. 

Cut No. 1093 represents this young lady at her desk. 

We have a customer who wears one of our artificial arms. He is 




No. 1094. 



engaged in a ticket office, where he sells many railroad tickets during 
the day. He works the dater with his rubber hand, and is considered 
as competent for his position as anyone in possession of natural hands. 

Cut No. 1094 represents Mr. Woolley of Wellesville, 0., stamping 
tickets. 

Cut No. 1095 represents a customer of ours who is a railroad con- 
ductor. He passes through the train, collects tickets, holds them by 
the fingers of the rubber hand, and punches them in the usual way. 

Cut No. 1096 represents a telegraph operator who writes messages 
with his rubber hand, while his natural hand is on the key. 



A. A. MAEKS, ARTIFICIAL LIMBS, NEW YORK CITY. 285 




No. 1095. 
Cut No. 1097 represents one of our customers who wears an arti- 




No. 1096. 



ficial left arm, and attends to the work of firing- a stationary boiler. 
He has followed this line of labor for many years. 



286 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 




No. 1097. 

Cut No. 1098 represents a physician whose right arm is artificial. 
He drives his own horse, and holds the reins in his rubber hand. 




No. 1098. 



Cut No. 1099 represents a patron whose left arm is artificial, and who 
rows a boat with his rubber hand. His occupation requires him to be 
in a boat a great part of the time. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



287 




No. 1099. 



Cut No. 1100 represents a farmer, whose right arm is artificial. He 
is able to plow, hoe, and perform almost any kind of farming work. 




No. 1100. 



Cut No 1101 represents a traveling gentleman, who finds an arti- 
ncial right arm of great service to him in carrying his valise. He has 



288 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 




No. 1101. 

the hand made so that it is nearly closed and kept in that position 
rigidly. 
Cut No. 1102 represents a patron who uses an artificial arm in a 




No. 1102. 



very dexterous manner. He inserts a fork in the hand. He is a 
"diner out," and always uses his artificial hand in managing the fork. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



289 




Cut No. 1103 represents Mr. W. G. Bray of Dunklin County, Mo. 
His left arm is amputated above the elbow; he has worn an artificial 
arm for many years. He is clerking in a store and has to handle all 
kinds of heavy merchandise. He wheels a barrow without difficulty. 




No. 1104. 



Cut No. 1104 represents Mr. Ely of Windham County, Conn., who 
writes that he has no difficulty in working with other laborers and 
earning laborers' wages, although lie has to do a great amount of work 
with the pickax. His right arm is artificial. 



290 A. A. MAEKS, AETIFICIAL LIMBS, NEW YOEK CITY. 

DIRECTIONS FOR TAKING MEASUREMENTS FOR ONE, 
OR A PAIR OF ARTIFICIAL ARMS. 

Place a sheet of paper (about twenty by thirty inches) on a smooth 
table, remove all clothing from the upper part of the body, place both 
arm and stump on this paper at full length. Be sure that the edge of 
the paper presses closely against the chest. Pass a long pencil down 





No. 1105. No. 1106. 

the inside of the arm, as represented in Cut No. 1105, around the fin- 
gers and up the outside to the shoulder. Then pass the pencil around 
the amputated side from body around end of stump, and up to the 
shoulder, as represented in Cut No. 1106. Bend the elbow of the 





No. 1107. No. 1108. 

sound arm to about right angles, mark around it from shoulder, 
around elbow, down the forearm around the hand, up the inside to 
the shoulder, as represented in Cut No. 1107. Bend the elbow of the 
amputated arm to right angles, and mark around it from shoulder 
around elbow, around end of stump, up the inside to the body, as 
represented in Cut No. 1108. If these diagrams are correctly taken, 
they will resemble Figs, 1109, 1110, 1111, and 1112. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



291 



With a tape line measure the distance from the point of shoulder to 
the point of elbow of sound arm, also the distance from the arm-pit to 
the bend of elbow. Measure the distance from the point of shoulder 
to the point of elbow of the amputated arm, also the distance-from the 
armpit to the bend of the elbow. Give the circumference of each arm 
at intervals of two inches, beginning close to the body. These circum- 
ferences are represented by dotted lines A, B, C, D, E, and F, of sound 
arm, see Cut No. 1109, and the dotted lines A, B, C, D, E, F, G, 
and H, in diagram of stump. See Cut No. 1110. Then give the cir- 
cumference of the hand at the base of the thumb, represented by dotted 





A.A.MA SJS^^ I A.A.MAJ*KSlj £ 

No. 1109. No. 1110. No. 1111. No. 1112. 

line G, then the circumference of the palm, at the base of the fingers, 
represented by dotted line H; then give the circumference of the 
thumb at the first joint represented by dotted line I. Cut No. 1109. 

If one arm is amputated in or above the elbow, the diagrams and 
measurements of the sound arm called for in Cuts Nos. 1105, 1107, 
and 1109 are required, and only one diagram of stump, together with 
circumferences at intervals of two inches; the distance from point of 
the shoulder to point of the stump, and the distance from the armpit 
to the point of the stump are also required. 

If both arms are amputated above the elbows, diagrams of each 
stump, and the distance from the point of each shoulder to the point of 
each stump, and from each armpit to the point of each stump ; also 
the circumferences of each taken at intervals of two inches. 

If both arms are amputated below the elbows, the diagrams and 
measurements may be taken as suggested by Cuts No. 1106, 1108, 1110, 
and 1112. 

All amputations in the shoulders, elbows, or wrists, or in the hands, 
leave extremities that are bony, more or less sensitive, and requiring 
very exact fitting. Such stumps should be reproduced in plaster. 

Answers to the following questions should be attached to the blank 
and forwarded with every order : Name of patient? Post-office address? 
Occupation? Age? Weight? Cause of amputation? When was am- 
putation performed? Which arm amputated? Has the patient worn 
an artificial arm? If so, whose make? Name of the party ordering? 
His address? Is the arm to be made and fitted from measurements in 
the absence of the wearer? To what address shall it be shipped? 



PART III. 
GENERAL INFORMATION. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



295 



INSTRUCTIONS FOR TAKING PLASTER CASTS 
OF STUMPS. 

Plaster casts are only required of stumps or deformed limbs on which 
there are prominences or irregularities that cannot be located by de- 
scriptions or diagrams. Amputations in the hip, knee, ankle, foot, 
shoulder, elbow, wrist, and hand, usually leave stumps that should be 
reproduced in plaster. Casts of such stumps are valuable helps in mak- 
ing fittings in the absence of the wearers. If the wearer intends to be 
fitted in person, it will not be necessary for him to send a cast, no mat- 
ter what character of a stump he may have. Several methods for tak- 
ing casts will be explained, and the one most suitable for the case can 
be selected. As there is some difficulty in mixing, spreading, and 
judging plaster, it is always better to engage some person familiar 
with the work. A dentist, a wax flower-worker, or a maker of plaster 
statuettes should be employed if available. For the guidance of those 
who desire to make their own casts, we will submit the following 
methods. 

THE SIMPLE METHOD. 

The stump of which the cast is to be made, should be divested of all 
clothing, and the hair and fuzz shaved off. Two quarts of plaster of 
Paris should be placed in a basin containing about one quart of water. 
The plaster should be mixed thoroughly, and then spread by a knife 
upon the stump. There should be at least one-half inch in thickness 
over the entire stump. Keep the stump quiet until the plaster has 
become hard. This should not take more than ten minutes. Then re- 
move the cast, the inside of which will be a counterpart of the stump. 



DIVISION METHOD. 

If the stump is larger at the end than immediately above, the cast 
will have to be taken in two parts, otherwise it will not be possible to 




A A.MARKS.NX 



No. 1113. 



No. 1114. 



draw the stump from the mold. The cast can be taken in two parts 
in two ways: First, by spreading a quantity of the mixed plaster on 



296 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



a board, then resting the stump on it. Pile up the plaster on the sides 
of the stump until it has reached the greatest diameter (see Cut No. 
1113), then lay pieces of thin wet paper on all the exposed surfaces of 
the plaster (see Cut No. 1114), then pour and spread plaster on top of 







No. 1116. 



the stump (see Cut No. 1115), let it run down the sides and on top of 
the paper. The plaster should be not less than half an inch thick. 
When it has become thoroughly hard, it will, by a little force, separate 
at the division line made by the paper, and the stump can be with- 
drawn. (See Cut No. 1116.) 



STRING METHOD. 

The "string method" is described and illustrated as follows: A 
strong, thin cord is passed down each side of the stump around the 




No. 1117. ' No. 1118. 

end, and held by the subject, as represented in Fig. 1117. The string 
must not be pulled very tightly. Spread a little plaster on the string, 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



297 



so as to make it adhere to the stump, as represented in Cut 1118. 
Work quickly and spread the plaster all over the stump, back, front, 
and sides, until there is a thickness of not less than half an inch on all 
the surfaces. Be sure and carry the plaster well up to the joint. As 




soon as it begins to harden, both ends of the string should be pulled 
downwardly (as represented in Cut No. 1119) as far as the end of 
the stump. This will cut the plaster mold into two longitudinal 
parts. As soon as the plaster has become hard, a knife or chisel can 





No. 1121. 

be inserted in the crease cut by the string, and by a little prying motion 
the mold will separate and can be removed from the stump, as repre- 
sented in Cut 1120. The two parts should be thoroughly oiled on the 



298 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

iasides, then put together ; a strong, cord should be passed around 
them, and a little plaster spread down each side and around the bot- 
tom so as to seal the seam. After this is done, enough plaster should 
be mixed to fill the mold. It should be thinner than before, and poured 
into the mold very slowly. See Cut No. 1121. After the mold has 
been filled it should be laid aside for two or three hours. The shell 
can then be broken off, and the cast obtained will be a fac-simile of 
the stump. This method is especially adapted to knee-joint, ankle- 
joint, foot, elbow-joint, wrist-joint, and part of hand amputations. 



PLASTER BANDAGE METHOD. 

An excellent method for taking a plaster cast of a flabby stump, or a 
stump that has to be compressed in order to obtain tight fittings, is 
known as the " plaster bandage method," explained as follows: 




No. 1122. 

Take five or six strips of cheese cloth or crinoline, or any other thin 
and open cloth, two inches wide and about twelve feet long, spread 
dry plaster on each, as shown in cut No. 1122; put only enough on to 
fill the meshes. Each strip should be rolled up snugly and separately. 
The stump should be made bare, and all the hair removed by shaving, 




No. 1123. 

or it should be made to lay down by thick soap. One plaster bandage 
roll should be immersed in water (see cut No. 1123), and kept there un- 
til bubbles cease to come to the surface. When well soaked it should 
be wound around the stump very tightly. Begin at the end and wind 
upwardly. See that every layer laps the edge of the preceding layer, 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



299 



and continue upward to the joint. Then work downwardly and 
around the end of the stump in several directions, then up again, and 
so on until every part of the stump up to the joint has been covered by 
about four layers. See cut No. 1124. For a long and large stump it 
will require at least five bandages of the width and length above noted. 




No. 1124. 

A small stump will, of course, require less. The bandages should be 
allowed to remain on the stump until they have become hard. This 
may take one or two hours, and possibly three, as the cloth holds the 
moisture a great length of time. Therefore, the plaster will not 
harden so quickly as it will in any of the methods previously described. 




..MARKS. 

No 1125. 

As soon*as it has become thoroughly hard, it should be drawn off the 
stump. See cut No. 1125. If it will not slip off easily cut through 
one of the sides so as to allow it to open and permit the obstructing 
part of the stump to pass. This bandage mold should be filled with 
sawdust, packed well, and sent to us; or if preferred, a cast can be 
made from the mold, as follows: Grease or oil the inside thoroughly, 
then fill it with thin plaster; as soon as it has become thoroughly hard, 
the plaster mold can be torn off and a facsimile of the stump will be 
obtained. 

In sending casts or molds, care should be taken to have them well 
packed in cotton, sawdust, excelsior, or hay, otherwise they will break 
in transportation. 



ARTIFICIAL LIMBS MADE AND FITTED FROM MEAS- 
UREMENTS WITHOUT THE PRESENCE OF 
THE WEARERS. 

The inventor of the rubber foot, Mr. A. A. Marks, has the credit of 
originating the scheme of fitting artificial legs and arms from meas- 
urements, without requiring the persons who are to wear them to 
leave their homes. During the early part of his experience as an 
artificial-limb manufacturer, he realized the importance of devising a 
scheme by which a person living in the most distant part of the land 
could, by the assistance of some member of his family, take his own 
measurements and diagrams and send them to the manufactory and 
i have an artificial limb constructed by them, with the assurance that 
it would fit his stump perfectly. The value of this scheme could 
not be overlooked, as it could not be expected that persons living in 
foreign countries, or in our own distant States and Territories, would 
submit to the expense or fatigue of a wearisome journey in order to 
get an artificial limb. Such journeys not only incur expense, but a 
great sacrifice of time, and when considered by a timid or a frugally 
disposed person, the alternative is more likely to be decided upon, that 
of accepting a makeshift that may be procured near at home, and 
foregoing the benefits of a modern limb made by a skillful manufac- 
turer. And if a makeshift cannot be procured, he will resign himself 
to crutches for the remainder of his life. 

Mr. Marks promptly set himself about to solve this problem. He 
collected all the data he had accumulated, made himself thoroughly 
acquainted with the anatomy of the extremities, and established the 
system that has been in operation for over thirty years. Many thou- 
sand artificial limbs have been made and fitted under that system; 
the results have been most satisfactory. Expressions of gratitude 
have come from all parts of the world commendatory of the system 
that opened up so many advantages to so many persons. European 
Princes, Oriental dignitaries, South American Generals, and thousands 
in affluent circumstances have shared the benefits equally with those 
who were so indigent that the expense of procuring an artificial limb 
£,lone would debar them of any other outlay. 

The system has put the artificial-limb maker in touch with the arti- 
ficial-limb wearer, no matter where he may be located or in what 
circumstances he may be situated. 

Our artificial limbs have been exported to every country on the face 
of the earth, and fully ninety per cent, have been manufactured from 
measurements without the presence of the wearers, and it is a very 
rare exception that the fittings are ever subject to criticism. 

We have patrons who live within a very few miles of New York 

300 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK: CITY. 301 

city, who are actively engaged in business, and who prefer to have 
their limbs fitted from measurements under the guarantees that we 
give, rather than absent themselves from their homes. 

We encourage persons who reside at a great distance to have their 
limbs fitted from measurements, and, in order to relieve them of finan- 
cial loss, we always assume the risks, by agreeing to make no charge 
for any reconstructions, refittings, or alterations, whether they are 
necessary on account of errors in measurements or peculiarities in 
the stumps. 

Instructions for taking measurements and diagrams are given so 
explicitly in this book that a person can hardly err in taking them. 
When they are received by us they are subjected to the closest scrutiny, 
and if errors and omissions have been made they are sure of being- 
detected, and corrections are immediately called for. As soon as the 
data is accepted we assume the risks and construct the required limb 
and send it to the wearer with full instructions for its application. If 
it fails to fit satisfactorily, the wearer is to communicate with us imme- 
diately, prompt advice will be given, and in all probability no further 
trouble will follow. 

Should the most improbable condition arise, and it is found that the 
stump possesses some peculiarity which requires another or a personal 
fitting, the wearer will be apprised of that fact and be requested to 
return the limb for such alterations as may be deemed necessary, or 
to come in person, it being understood that no charge will be made for 
refittings or reconstructions. 

We do not see how any stronger safeguard can be established that 
will protect the purchaser. 



WHERE WE ARE LOCATED. 

If, after all the facts presented in the preceding article are fully con- 
sidered, the reader concludes that it is wise and prudent for him to 
come to us and be fitted personally, he will find himself welcome to 
our establishment, where he will be attended to promptly on his arrival, 
and will not be required to remain longer than is absolutely necessary. 

We are located centrally, and are easily accessible from any of the 
railroad or steamboat landings. We will meet any person at the 
station on his arrival, if he will let us know, a day or two in advance, 
the time, day, and train on which he will arrive in New York, and the 
landing or station where he desires to be met. 

In the event of arriving here unattended and not acquainted with 
the city, the following suggestions may be of value: 

If the arrival occurs between the hours of seven in the morning and 
five in the afternoon, take any cross-town car at the station, ferry, or 
pier, go to Broadway and transfer to a Broadway car, ask the con- 
ductor to inform you when he reaches Fourth Street. We are located 
on the west side of Broadway, one door north of Fourth Street. 



302 a. A. MARKS,- ARTIFICIAL LIMBS, NEW YORK CITY. 

If the arrival occurs after five o'clock in the afternoon, it will be 
better to go directly to a hotel and remain there until morning. The 
Broadway Central Hotel is located at No. 671 Broadway, which is 
within two and a half blocks of our establishment. Accommodations 
can be had at that hotel at reasonable rates. The St. Nicholas Hotel 
is located at No. 4 Washington Place. This is within one block of our 
establishment. The rates are moderate. 

New York city is complete with cable, electric, elevated, and horse- 
cars, and a person can get from one place to another very conveniently 
without walking any great distance. 

Our establishment, located at 701 Broadway, is less than two miles 
from the Grand Central depot, where the New York Central & Hudson 
River Railroad, the New York & Harlem Railroad, and the New York, 
New Haven & Hartford Railroad terminate. It may be expected 
that anybody arriving from the New England States will be brought, 
to this depot. We are a little less than three miles from the Forty- 
second Street ferry, which is the terminus of the West Shore Railway. 
We are less than one mile from Christopher Street ferry, which is the 
terminus of the Delaware, Lackawanna & Western Railroad, and the 
Morris & Essex Railroad. We are less than one mile from Chambers 
Street ferry, which is the terminus of the Erie Railway. We are less 
than a mile and a half from Desbrosses Street ferry, which is one of 
the termini of the Pennsylvania Railroad and the Lehigh Valley Rail- 
road. We are a mile and a half from Liberty Street ferry, which is 
the terminus of the Central Railroad of New Jersey, Baltimore and Ohio 
Railroad, and the Philadelphia and Reading Railroad. We are two 
and a quarter miles from Thirty-fourth Street ferry, which is the 
terminus of all the Long Island railroads. We are two and a half 
miles from the Battery. 

These distances are given for the information of persons who desire 
to engage hacks upon their arrival in New York. A one-horse hack 
cannot legally collect more than $1 for conveying one or two passen- 
gers a distance not exceeding two miles, and $1.50 for over two miles 
and not exceeding three. A two-horse carriage has the privilege of 
charging more. 

It will thus be seen that$l or $1.50 is the most that can be legally 
charged for conveying one or two persons from any railroad station or 
ferry to our place when a one-horse vehicle is engaged. 

It is always best to make a bargain with the driver before entering 
his vehicle, and pay him the amount agreed upon as soon as he has 
brought you to our store. 

No person should consider it necessary to be conveyed by a carriage. 
Surface cars can be boarded at any station. They are accommodating, 
and no matter how greatly a person may be crippled, be can reach us % 
by street cars with little or no annoyance, and the expense will be no 
more than five or ten cents. 

Policemen can always be found at stations, ferries, and piers. 
Their duties are not only to protect persons and property, but to give 
such directions and information as may be needed by strangers. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 303 

Boarding and lodging accommodations can be obtained at reason- 
able rates. Furnished rooms in private houses can be rented at from 
$2 to $5 per week, according to location. Good table-board can 
be had at from $3 to $5 per week. Hotel accommodations, includ- 
ing board and lodging, can be had at from $2 to $5 per day. By 
engaging a furnished room and eating in restaurants, living expenses 
in New York can be kept within very low figures. 

Upon leaving home instructions should be given that letters and 
telegrams may be addressed to the care of A. A. Marks, 701 Broadway, 
New York. They will be promptly delivered to the parties to whom 
they are addressed, or held until called for. - 

Our patrons are welcome to the accommodations of a fire-proof safe, 
in which valuables and money can be deposited. They have the liberty 
of our premises while they tarry in New York, and if they are shop- 
ping they can have their goods delivered here. Or can make engage- 
ments and meet parties here, and have the exclusive use of private 
rooms for private interviews. 



CALLS MADE TO RESIDENCE. 

Persons within the limits of New York city, Brooklyn, or Jersey 
City will be called upon at their residence when requested. Consulta- 
tion, measurements, and advice will be given free of charge. Persons 
living outside of those limits will be called upon by a competent person 
who will examine their stumps, give advice, take measurements, and 
attend to their needs, if traveling and hotel expenses and the extra 
time consumed in traveling are paid for. 



LADY ATTENDANTS. 

Ladies who prefer to be attended by one of their own sex will find 
ladies in our office who are competent to attend to their wants, take 
measurements, fit and adjust artificial limbs. 



BRANCHES. 

We have no branches. We are established in New York city, and 
in no other place. Our profession is analogous to that of a surgeon. 
Our skill and judgment, which are so frequently required, cannot be 
transmitted to a manager of a branch office. If we were to establish 
branches we would have to place them under the management of 
others, and thus would more or less jeopardize the welfare of our 
patrons. We have been forced to this conclusion by experiments that 
we have made. To take the place of branches our system of fitting 
from measurements has been devised, which has been found to be 
thoroughly satisfactory. 

Physicians, druggists, truss, and instrument makers can be found in 



304 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

almost every city and town, who will take measurements and attend 
to the details of ordering, if they are called upon. 

If the reader desires to order a limb, and does not care to take the 
measurements himself, he can call on his physician or his druggist, or 
can go to a neighboring town where there is an instrument maker, 
and have his measurements taken, and the details of ordering at- 
tended to. 



PRICES. l 

The prices for artificial legs and arms described in this book are 
given with each and every kind. They will be found among the de- 
scriptions. Briefly they are as follows : 



LEGS. 

Artificial legs for hip-joint amputations, with suspenders and all 

necessary attachments, each, 

Artificial legs for thigh stumps, with necessary suspenders, each, 100 
Artificial legs for knee-joint stumps, with necessary suspenders, 

each, . 100 

Artificial legs for knee- bearing stumps, with necessary suspen- 
ders, each, 100 

Artificial legs for below-knee stumps, with necessary suspenders, 

each, 100 

Artificial legs for ankle-joint and partial feet stumps, when knee 

and thigh supports are necessary, each, 100 

Artificial legs for ankle-joints and partial feet stumps, when knee 

joints and thigh pieces are not required, each, . . .50 

Artificial legs for below knee stumps, without knee-joints and 

thigh supports, with suspenders and thigh straps, each, . . 65 
Artificial feet for partial feet amputations, from . . $30 to $50 

Apparatus for deformities, when knee joints and thigh supports 

are required, each, . . 100 

Apparatus for deformities where knee joints and thigh supports 

are not required, each, . 50 

Extensions for shortened legs, when the legs from the knees down 

have to be encased, each, 50 

Extensions for shortened legs, where ankle-joints only have to be 

supported, each, 30 

Extensions for shortened legs that do not extend above the feet, 

each, .30 

Peg legs for thigh amputations, provided with knee joints, including 
suspenders, each from $50 to $75, according to finish. 

Peg legs for thigh stumps, without knee articulations, with neces- 
sary suspenders, each, $25 to $40, according to finish. 

Peg legs for knee-bearing stumps, with knee articulations, with nec- 
essary suspenders, each, $50 to $75, according to finish. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 305 

Peg legs for knee-bearing stumps, without knee articulations, with 
necessary suspenders, each from $25 to $40, according to finish. 

Peg legs for below knee stumps, with knee joints and thigh sup- 
ports, each, from $30 to $50, according to finish. 

Peg legs for below knee stumps, without knee joints or thigh sup- 
ports, with thigh straps, each, $20 to $30, according to finish. 
Peg legs for knee-bearing or below knee stumps, made to bear 

upon the flexed knees, style 819, each, $15 

Suspenders of various kinds, consult pages 167 to 177. 

Supplies for artificial legs, consult the last pages. 



ARMS. 

Artificial arms for amputations in the shoulders or above the 
elbows, with necessary suspenders, each, . $75 

Artificial arms for amputations in the elbows or immediately 
below, but too short to control the elbow movements, with 
necessary suspenders, each, . . . : . 75 

Artificial arms for stumps between the wrists and elbows, with 
steel side joints, each, ..." 50 

Artificial arms for stumps between the wrists and elbows, with 
duplex elbow joints, each, 50 

Artificial arms for stumps between the wrists and elbows, with 
leather side joints, each, 50 

Artificial arms for wrist-joint stumps, with elbow joints and up- 
per-arm pieces, each, 50 

Artificial arms for wrist stumps not requiring elbow joints or 
upper-arm pieces, each, 30 

Artificial hands for partial hand amputations, each, ... 50 

Artificial hands or parts of hands for deformities, each, . . 50 

Artificial fingers from $30 to $50 each. 

Peg arms for shoulder and above elbow amputations, with elbow 
joints and necessary suspenders, each, 65 

Peg arms for shoulder and above elbow amputations, without 
elbow joints, with necessary suspenders, each, ... 40 

Peg arms for amputations in the elbows or immediately below, 
requiring elbow joints, with necessary suspenders, each, . 65 

Peg arms for amputations in the elbows or immediately below, 
without elbow joints, with necessary suspenders, each, . . 40 

Peg arms for amputations between the elbows and wrists, with 
steel duplex or leather elbow joints and necessary suspenders, 
each, 40 

Peg arms for amputations between the elbows and wrists, with- 
out elbow joints, each, . . . . . . . .35 

Peg arms for wrist-joint amputations, each from $20 to $30. 
Suspenders of various kinds, consult page 279. 

Implements for artificial arms, consult pages 280 to 2S2. 



306 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY; 



ACCESSORIES. 

Artificial legs are furnished with the following accessories without 
additional charge : 

Legs for thigh and knee-bearing stumps. The necessary suspenders 
attached ; one sock for each stump, screw-driver, box of grease, extra 
spring. 

Legs for below knee stumps : Necessary suspenders attached, one 
long and one short stump sock; pocket oil can, screw driver, extra 
lacing. 

Legs for ankle joint and partial feet stumps : Sock for stump, extra 
lacing, and necessary felt lining. 

Artificial arms : Necessary suspenders attached, sock for stump, 
knife, fork, hook, brush, pair of kid gloves (except when arm is or- 
dered without a hand). 

Artificial legs and arms will be delivered to any person residing in 
the limits of New York City, Brooklyn, and Jersey City, or will be 
boxed and delivered to express office in New York City without 
additional charge. 



TERMS OF PAYMENT. 

Payment is required in advance with every order. If preferred one- 
half can be advanced with the order, and the balance paid on delivery. 
This is the plan on which payments are expected for everything that 
is made to order, from a suit of clothes to the building of a house, and 
it is considered to be in conformity with good business methods. 

Every assurance is given.that the interests and the welfare of the 
wearer will be subserved in the construction of the limb. 

It is of the greatest importance to the manufacturer that his client 
shall be satisfied, not only with the fit and workmanship of his arti- 
ficial limb, but that he shall become clever, skillful, and dexterous in 
its use, and thus reflect credit to the maker. The manufacturer 
cannot afford to neglect or hastily dismiss a case or show a lack of 
interest, or the least hesitancy in doing everything that is possible 
for the relief and comfort of his patron — his reputation is at stake. 
His business suffers if his patron complains of his treatment. No 
well-established house can afford to displease a customer or receive 
his ill will. 

Wisdom and shrewdness compel the strictest integrity in the dis- 
charge of every obligation ; trouble and financial losses are not to be 
considered when disappointment and displeasure can be averted. No 
establishment can exist long that becomes careless or allows its conduct 
to be criticised. 

The proposition to place money for the payment of the limb on 
deposit with some bank, to be paid to us as soon as the limb is 
received and found to be satisfactory, is often suggested. We decline 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 307 

to accept of such terms, as mouey so deposited is subject to such con- 
ditions that the feature of security is removed. The money cannot be 
drawn unless the party ordering the limb gives his consent. If he 
declines to accept of the limb from whims or caprice, he can demand 
his money and we have no redress. 

We have no objections to delivering our goods to druggists, mer- 
chants, or any other business house which enjoys an acceptable 
mercantile standing. It must always be understood, however, that 
the goods they order must be accepted and paid for. "We, of course, 
are under obligations to supply goods that are free from faults and 
defects, and covered by the guarantees given in this book. 



INSTALLMENT PAYMENTS. 

We are willing to accept of payments on the installment plan, pro- 
vided such obligations are imposed as will make the payments abso- 
lutely sure. We will require the first payment to be not less than 
one-quarter the value of the limb ordered; the balance can be paid, in 
large or small amounts, weekly or monthly, as may be desired. We 
require all deferred payments to be secured by some reliable business 
man. 

Upon request, we will forward an installment blank, which is to be 
filled out by the purchaser. The dates and amounts of deferred pay- 
ments are to be properly specified. The guarantee attached to that 
paper is to be filled out and signed by one or two acceptable business 
men. We shall insist upon the guarantors being business men, as we 
can more readily ascertain their business standing and reliability, 
which are reported by commercial agencies. Professional men, such 
as ministers, lawyers, and doctors, also farmers, retired men, em- 
ployees, and agents, are not rated by any commercial agency ; there- 
fore, it would be difficult for us to ascertain their commercial standing. 

We believe that there are but very few dishonest persons in the 
world. It is a very rare exception 'that we find a person whose 
motives and impulses are void of integrity. Many promises are made 
in good faith ; but, on account of the inability to fulfill such promises, 
they go by default. A poor man needs an artificial limb ; he is with- 
out money, and his pride keeps him from begging; he has the promise 
of a situation as soon as he gets his limb; the future is, indeed, very 
promising and bright. He may go to his minister or his doctor and 
appeal to him, and it is almost certain that he will be met with favor, 
and the clergyman or the doctor will promise to go security for him; 
the limb is obtained, the man wears it, he gets his situation and earns 
his wages ; he becomes a little careless in his expenditures, or some 
relative or dear friend becomes afflicted and requires some financial 
help from him. The time arrives for payment to be made, and the 
young man has no money. The minister or the doctor who has 
guaranteed the payments feels that it is unjust to be called upon to 
make the payments. He writes a pitiful letter, and time is extended. 



308 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

This is repeated until patience becomes exhausted, and drastic meas- 
ures have to be resorted to. It suddenly dawns upon the manufacturer 
that it would be poor policy to force payment out of the minister or 
to make enemies with the doctor, and the matter is dropped: the 
manufacturer suffering the entire loss. 

This is an old, old story, so often enacted in life that the manufac- 
turer has been forced to accept of none as guarantors except men 
engaged in business who have acceptable mercantile standing, and are 
prepared to meet their obligations. 

OUR GUARANTEE. 

Every leg and every arm delivered from this establishment is 
protected by the following guarantee : 

The material'that is used in the construction of the limb; the work- 
manship by which the parts are put together ; and the adaptability to 
the needs of the wearer are guaranteed to be faultless. Should any 
defects in material, workmanship, or construction be present, we, by 
this guarantee, are required to remove such defects without charge. 

This guarantee is to be in force for a period of five years from the 
date of the delivery of the limb. 

The limb is to be returned to us immediately upon such defects 
presenting themselves. The limb must not be neglected, abused, or 
permitted to meet with violence. 

We are not obligated to reconstruct a limb without a charge, in 
order to accommodate a stump that has grown larger or reduced in 
size after one perfect fitting has been made. 

A copy of this guarantee is delivered with every limb. 

We consider that this guarantee is an honest one; it protects the 
purchaser to the fullest limit, and at the same time protects the maker. 

A guarantee is not an insurance. Some persons think that if an 
artificial limb, a watch, or a bicycle is guaranteed, that the maker is 
required to keep the article in perfect repair for a specified time, 
whether the need of repairs is caused by abuse, violence, or accident. 
This is an error. An artificial limb, the same as a watch or a bicycle, 
is guaranteed to be free from defects — to withstand the use and the 
work that the wearer is expected to give to it in the ordinary pursuits 
of life. 

If the limb becomes out of order or damaged through abuse, neglect, 
or violence, the wearer will be required to pay for the repairs that are 
needed. 



HOW SOON AFTER AMPUTATION SHOULD AN 
ARTIFICIAL LIMB BE APPLIED ? 

Reason and experience agree : that the proper time to apply an artifi- 
cial leg to a new stump is as soon as possible after the stump has healed 
and the patient has recovered from the shock. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 309 

When the patient has gained strength enough to move about on 
crutches and maintain his equilibrium, and his stump has healed, it is 
time that an artificial limb should be applied and worn. Nothing can 
be gained by waiting beyond that period. Delays are attended with 
dangers. A person walking on crutches is in constant peril; if his 
crutch breaks or slips he is in danger of falling and landing on the end 
of his stump. This occurrence is not rare ; if it were we would not 
mention it. So many persons have fallen and injured their stumps 
that we feel it a duty to call attention to the danger. We have known 
of falls that have injured the ends of stumps so severely that secondary 
amputations have had to be made in order to remove splintered bones, 
bruised tissue, or disarticulated joints. If an artificial leg did nothing 
but protect the stump, it would pay for itself many times over. 

Delay in applying an artificial limb gives the stump an opportunity 
to become enervated from disuse, soft, flabby, and large from lack of 
exercise. Joints are liable to become limited in their range of motion 
unless they are kept in activity. An artificial limb has a wholesome 
influence upon the stump. It induces a health-giving activity, main- 
tains normal mobility in the joints, keeps the muscles properly devel- 
oped, prevents sluggish circulation, and protects the stump from injury 
in case of falling. 

We have applied limbs within a month after amputations with whole- 
some results. In the greater number of cases this interval is too brief. 

It is impossible to state how much time should elapse between the 
surgical operation and the mechanical application. It is safe, however, 
to be governed by the following rule : 

Apply an artificial limb as soon as the stump is healed and the 
patient has regained his strength. 

It is a common error to assume that a stump will become hard and 
tough by time. Nothing can harden and toughen a stump except use. 
A stump will n*ever become hard and tough until it is disciplined by 
an artificial limb. The hands of a laborer are strong and hard because 
he uses them in performing his work. The hands of a person not 
accustomed to manual labor are soft, tender, and delicate and become 
easily blistered, simply because they have not been disciplined. The 
same principle is applicable to stumps. 

Surgeons appear to be at variance in their views on this subject. 
Some advise a premature application, while others advise the patients 
to wait six months or a year. The thoughtful surgeon will see that no 
time can be specified, that all depends on the condition of the case. 
The rule above suggested can govern him with safety. The following 
correspondence on this subject will, we hope, be read with interest : 



Stephen G. Cook, M. D., Ill West Twelfth Street, New York City. 

Dear Doctor : Your experience as a surgeon and physician, and more espe- 
cially as United States Government inspector of artificial limbs, enables you to 
exercise a practical as well as a theoretical knowledge upon the very important 
yet open question of what constitutes a proper period that should elapse 
between the amputation of a limb and the application of an artificial one. 
You are doubtless aware that upon this subject surgeons diii*er very widely. 



310 A. A. MARKS, ARTIFICIAL LIMBS, NEW TOEK CITY. 



I desire to obtain your opinion for publication, and if you can see no impro- 
priety I will thank you if you will write your views upon this subject. 

Yours very truly 

A. A. Marks. 



REPLY. 

Mr. A. A. Marks. 

Dear Sir : Your letter, asking my opinion as to the length of time to inter- 
vene between the amputation of a limb and the application of an artificial one, 
has been received, and in response I would say that I would allow just as long 
a time to elapse as is necessary for the thorough healing of the stump, and no 
longer. 

In my opinion there are at least three good and sufficient reasons why the 
interval should be brief, to wit : 

First. Because by disuse the muscles left by the amputation, and which in 
the future are to control the action of not only the stump but also of the arti- 
ficial limb thereto attached, become undisciplined ; that is to say, they lose 
the nice co-operation there is naturally between them and the will-power. 

That muscles act under the strictest discipline needs no further evidence 
than to watch the skillful movements of any trained artisan and compare 
them with the bungling movements of the unskilled, the untrained, and the 
undisciplined. After an amputation the muscles left are necessarily for a 
time unused, and if left too long, lose the power of responding to and being 
governed by the will. The application of the artificial limb is the first impulse 
that arouses them from their long period of inactivity ; hence, in my opinion, 
it should be applied just as soon as practicable after the stump has healed. 

Second. My second reason is based upon the old physiological law that 
"action increases strength." Compare the muscular development of the 
blacksmith, the boat-rower, the trained athlete and gynrnast, with those of 
gentlemen of leisure and pleasure, and the adage needs no further proof. The 
muscles of an amputated limb not only become undisciplined, but they also 
become atrophied, shrunken, and effeminate, and the longer they are unused, 
the more atrophied they become. The shrinking of the muscular tissues is 
supplemented by a deposit of adipose tissue (fat), so much so that sometimes 
when the manufacturer of artificial limbs is applied to, he finds, instead of a 
hard and firm stump, what has more of the appearance of a mass of quivering 
jelly. 

Third. My third reason is applicable to the loss of a lower limb only, and 
refers to the use of crutches. Under the most favorable circumstances it is a 
difficult task to learn to use an artificial leg skillfully and naturally, a task 
that some learn much more readily than others, the same difference existing be- 
tween individuals in this respect as in learning a science or a trade. The 
patient who has learned to balance himself upon a pair of crutches, and to get 
along as rapidly and almost as easily as before he was injured, is very apt to 
become both discouraged and disgusted when, on the application of an artifi- 
cial limb, he discovers he has to learn the art of locomotion all over again. 
Under such circumstances, unless possessed of more than the usual share of 
energy and determination, he is too apt to lay the artificial limb one side for 
intervals too long to enable him to become speedily accustomed to its use. 

For these and other reasons that might be mentioned, my experience of over 
thirty years as surgeon both in civil and military life, as well as inspecting 
surgeon of artificial limbs for the United States Government, has led- me to the 
conclusion that the period of time that should elapse between the healing of the 
stump and the application of the artificial limb cannot be too brief. 
Yours very truly, 

S. G. Cook, M. D., 
Ill West Twelfth Street, New York City. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 311 



MANUFACTURER TO THE U. S. GOVERNMENT. 

It has been the purpose of the United States Government since 
the early part of the Civil War (1861-1865) to furnish artificial 
limbs to every soldier, sailor, enlisted, or hired man, commissioned 
and non-commissioned officer of the army and navy, who lost a leg 
or arm, or both, while in the naval or military service of the United 
States. 

In 1862 the first law bearing upon this subject was enacted by Con- 
gress. That law limited the issue of artificial limbs; but it was soon 
amended so that its benefits became more extended. In 1870 a new 
law was passed, wmich supplied artificial limbs to every person honor- 
ably discharged from the military or naval service of the United States 
who had lost a leg or arm, or the use of one or more of his members, 
while in the United States service, and repeated the issue every five 
years. That law was in operation for twenty years, and many thou- 
sand artificial limbs were supplied. In the early part of 1891 the 
Congress of the United States enacted additional pension laws and 
added to their lists hundreds of thousands of soldiers who had never 
before received a pension, or who had never dreamed of receiving any 
gratuity outside of the bounties which had been paid to them in times 
past. The same Congress that passed the invalid pension laws adopted 
measures by which additional benefits should be given to beneficiaries 
of the artifical limb laws, by changing the intervals of issue from five 
to three years, notwithstanding the fact that the Surgeon-General's 
Office exhibited records that proved that artificial limbs lasted more 
than eight years on an average, and that there was no necessity of 
abridging the frequency by which the soldiers could be supplied at 
Government expense. But Congress was determined that the maimed* 
should receive additional benefits, and the three-year interval became 
a law, which can be briefly stated in the following words: 

" Every officer, or enlisted or hired man, who has lost a limb or the 
use of a limb in the military or naval service of the United States, is 
entitled to receive, once every three years, an artificial limb or appa- 
ratus. The period of three years is reckoned from the last maturity 
subsequent to March 3, 1888. 

"Necessary transportation to the manufactory and return, by the 
most usual and direct route, will be furnished to those desiring it, for 
the purpose of having artificial limbs fitted; but will not be furnished 
except for this purpose. Sleeping car accommodations will be given 
upon request." 

Those whose maturity under the old law occurred between March 3, 
1886, and March 3, 1888, were given a new date of maturity, namely, 
March 3, 1891 (the day the bill became a law). 

As manufacturers to the United States Government, we have been 



312 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

required to furnish bonds with two sureties, of five thousand dollars 
each, for the faithful performance of our work. 

Records show that we have furnished at least three-quarters of the 
applicants with artificial limbs. 

The favor with which our methods of construction is esteemed by the 
soldiers, is flattering and complimentary, and we feel under great obli- 
gations to them for the work which they have done in furthering our 
interests. The maimed pensioners of the United States are endowed 
with common sense. They are steady, reliable persons, an d^ apprecia- 
tive. They like common-sense limbs, and select those that are reliable, 
and which experience has taught them are worthy of their confidence. 
These are the reasons why our soldier patrons of 1865 are our soldier 
patrons of to-day. 

Blank applications for Government artificial limbs and transporta- 
tion will be sent upon request. These can be filled out, signed, and 
mailed to us. As soon as we receive them we will ascertain the date 
that the applicant will be entitled to anew limb, and at the proper time 
pass them to the officials at Washington. 

Those who reside at a great distance, and do not care to travel, can 
remain at home and have their limbs constructed and fitted from 
measurements. We extend to them every protection, every assur- 
ance, every guarantee, and assume every risk, the same as we (Jo to 
civilians. 

We have on file the measurements, diagrams, records, and dimen- 
sions of all the artificial limbs that we have made during the past 
forty- # three years, and can duplicate any limb, if so desired. If a 
soldier wishes to have a limb duplicated, in length, dimensions, 
fitting, or details of construction, he will be accommodated upon 
request. 

We advise every pensioner to procure artificial limbs under the laws, 
and apply for them promptly upon the maturity of their claims, and 
lose no time. 

When changes are made by Congress, the laws in force up to that 
time are always repealed. No one can predict what Congress will do. 
During the past few years the tendency has been to retrench aifd 
economize in the administration of public affairs, and much has been 
said, and more mooted, derogatory of the Government's liberality to 
the soldiers. As soon as that sentiment becomes more firmly molded, 
there is no doubt that some radical changes will be made, and the 
soldiers will be the sufferers. 



OUR RECORDS. 

We have a very complete record of the beneficiaries of the United 
States limb law, and know when many are entitled to new artificial 
limbs from the Government. 

The three-year amendment not only changed the frequency of issues, 
but changed the dates of many ; and as pensioners seldom keep the rec- 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 313 

ords of their own cases, they like to be informed when the time arrives 
for them to apply for new limbs. We make it a point to keep our cor- 
respondents posted upon this matter. We keep a faithful watch of the 
doings of Congress and the rulings of the several departments. Any 
pensioner who desires to be placed upon our list for his own benefit 
can send his name, address, rank, company, and regiment, and he 
will receive every attention, without being placed under any obligations 
whatsoever. 

THE LONGEVITY OF THE MAIMED. 

There appears to be a belief, shared by the medical profession as well 
as by the laity, that the amputation of one or more of the limbs from 
the human body necessarily entails an abridgement of the allotted 
number of days of his existence, and that there is a law that estab- 
lishes a ratio between the length of the life of the normally equipped 
man and that of the dismembered man. That the ratio is according to 
the extent and gravity of the dismemberment — the greater the quan- 
tity of limb removed the greater the abridgment. If a man is born 
to live three-score years and ten, provided he retains all his limbs, the 
loss of one limb will take at least ten years from that allotment ; and 
if he loses two limbs the lopping off of a few more years will be the 
sequence. This supposed curtailment is attributed to the shock that 
the nervous system receives by the injury and the amputation. 

Although "this theory has been advanced by men whom we 
would gladly accept as authority, we have doubted that the subject 
had ever received a thorough investigation, and have been induced to 
believe that the theory is nothing more than the blundering surmise of 
some opinionated individual. 

A rather cursory search for authority has failed to disclose anything 
reliable on the subject on which can be established any law that 
governs such cases. 

During our career as protheticians we have had excellent opportu- 
nities to look into the matter. By looking over our records, which 
comprise the histories of many thousand crippled persons, we arrive 
at the conclusion that the dismembering of the human body plays no 
part whatever in shortening life. Our records date back to 1853. 
Forty-three years have now elapsed, and it is an astounding fact that, 
of the entire number of our patrons, less than twenty-five percent, 
have died, and most of those have died from old age or accident; and 
in no case can we learn of a death that can be directly ascribed to the 
loss of a limb. We know of very few persons wearing artificial limbs 
who have suffered or died from pulmonary or cardiac diseases, and 
those who have died from those diseases were affected before their 
limbs were amputated. It is not an uncommon occurrence to have 
patrons call upon us who are over seventy years of age, and who enjoy 
excellent health. 

As we investigate this subject more thoroughly we are persuaded 
that amputations enhance vitality, and render it not only probable 



314 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

but positive, that on account of amputations, the lives of the subjects 
will be prolonged and free from disease. 

It is a prima facie fact that diseased and mangled limbs will cause 
death if they are not removed, but this is not the phase of the question 
that we are discussing. Will the length of life of the person who has 
had his limb removed, on account of disease or injury, be less or greater 
than it would if his limb had never been diseased or injured, and had 
never been removed ? 

It is absolutely impossible to give a categorical reply to this question. 
But we assert, that by deductive reasoning we are brought to the con- 
clusion that there is a compensation for the loss of the limb, and that 
that compensation lies in good health, prolonged life, and immunity 
from disease. 

Rev. Edward Beecher reached the age of eighty -four. Evidences of 
decline had begun to show themselves. By making a false step he fell 
from a railroad train and had one of his legs so badly crushed that it 
had to be amputated. He recovered from the operation and had an 
artificial leg applied. He lived for eight years and enjoyed excellent 
health and remarkable physical strength and mental energy. It was 
his custom to take long walks every day, to preach strong and enthu- 
siastic sermons on Sunday, lead prayer meetings during the week, per- 
form the rites of marriage and burial, and attend to all the branches 
of his clerical work, almost to the hour of his death. Wade Hampton 
is. now over eighty years of age. He had a leg amputated a num- 
ber of years ago, and has worn an artificial one ever since. He is 
mentally and physically strong, and moves about with agility. Gen- 
eral Daniel E. Sickles is over seventy-three years of age. He lost a leg 
in the War of the Rebellion, and has walked on crutches for over thirty 
years. He is seldom ill, has no organic disorders, is constantly about, 
mingling with lawyers and statesmen, ready at any moment to make 
a patriotic speech. John Pearson is now over eighty years of age. 
He lost a leg when past the meridian of life, and since that time 
has enjoyed vigorous health, is physically and mentally strong, 
and is noted for his great executive ability. He is constantly at his 
desk directing the management of his railroad enterprises. General 
Butler, General Wager Swayne, and scores of others who are promi- 
nent in state, legal, military, and industrial pursuits, whose names are 
prominently before us, are living examples of men who have been 
deprived of their limbs for a number of years, and are now beyond 
the Biblical allotment of life. These are, to our mind, indisputable 
evidences that nature amply compensates for the empty sleeve and the 
dangling trousers' leg. 

The writer has never heard of a cripple becoming insane. He can 
recall but very few cases where cripples have committed suicide. The 
mental as well as the vital forces appear to become stimulated by the 
dismemberment. 

Dare, Melrose, Conway, Leland, and Fitzpatrick are one-legged acro- 
bats whose muscular developments are the envy of the world. Few 
possessed of natural limbs can vie with these athletes. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 315 

It is a noticeable fact that persons who lose their legs become very 
powerful in their arms, large in chest, and great in girth, and persons 
who lose their arms become powerful in their legs and large in girth. 
The loss of parts of the body conduces to health, life, and develop- 
ment. 

A reasonable explanation may be found in the hypothesis that the 
removal of a part of the body lessens the demand on the vital forces 
and permits the supplying reservoirs to contribute more abundantly to 
the remaining members. If it overtaxes the heart to force the blood 
through all the avenues of the body, will not the labors of the heart 
be lessened if a few of those avenues are forever removed ? And will 
not the remaining avenues receive a larger share of the life-giving 
essences ? If the nervous system is overburdened, will not the tax be 
lessened if a part of the nerve organization be removed ? If a tree is 
permitted to grow at will it will sap itself by the many choking 
branches that grow from its trunk. The cutting off of these branches 
and the trimming up of the limbs always give new vigor to the tree. 
It will grow larger, stronger and will live longer. 

It has been said that a maimed person takes better care of himself, 
does not expose himself to the elements, or to the dangers that beset 
human beings ; that, on account of being crippled, he is compelled to 
be more cautious than others ; he cannot indulge in that riotous, ine- 
briate life which wrecks so many lives. In this connection we will 
say, and we speak from knowledge, that a person who is deprived of 
one or more of his limbs is not necessarily a convert to a life of virtue. 
He is not the sober man, the teetotaller, or the epitome of morality that 
some persons think he is. He goes through life in the same careless 
manner as other mortals, doing what he ought to do, and many times 
what he ought not to do. He sometimes observes propriety, but often- 
times is reckless, the same as his companions. He becomes drunk and 
indulges in excesses the same as others. There are, however, many 
maimed persons who are sober, industrious, thoughtful, prudent, and 
religious. The same habits, indulgences, and discretions that are 
found among those in possession of their natural limbs are found in 
about the same proportion among those who have been amputated. 
The loss of a part of the anatomy does not affect the morale. 

It is an error to suppose that the loss of a limb induces despondency. 
There will not be found a class of people on the face of the earth who 
are less lugubrious and who lament their losses as little as that class of 
truncated humanity who have abbreviated extremities. We recall the 
visit of a man some years ago who had both of his legs and one arm 
amputated. After reciting a harrowing tale of a railroad collision and 
fire, and weeks of suffering at the hospital, and his recovery to health 
with only one of his four limbs remaining, he closed his narrative with 
the ejaculation: "Thank God, it was no worse!" This illustrates 
fairly well a crippled man's disposition. He is more thankful that he 
has not lost more, than he is regretful for having lost so much. He is 
constantly meeting with persons who, in his mind, have met with 
greater hardships than himself. It is an ordinary occurrence for a 



316 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

one-legged man a meet a one-armed man, and for each to say of the 
other, " I prefer to be as I am rather than as you are." 

A cripple is neither a cynic nor a pessimist. His misfortunes have 
driven from him whatever there may have been of the misanthropic. 
He is always in good health. He is, therefore, a better, a happier, and a 
more contented man than the dyspeptic, the rheumatic, or the gouty 
man, who is in possession of all the limbs that he is entitled to. It is 
a common occurrence for a man wearing two rubber feet to take con- 
solation from the fact that he can never be troubled with corns, gout, 
or suffer the excruciating pain of having some ponderous lout tread on 
his feet. 

Nature, with her usual generosity, compensates for every misfor- 
tune. We look about us and see conditions that are appalling, and are 
impelled to pour out our commiseration; but we little think how use- 
less, how unsolicited, and often how uncharitable it is for us to do so. 
Those that are the most afflicted need our commiseration the least. 
Their minds and dispositions have already been prepared by Nature to 
bear their misfortunes, and they dislike to have others notice or men- 
tion them, much less to shed tears over that which they so little regret 
themselves. 



AMPUTATIONS PROTHETICALLY CONSIDERED. 

Read before the Section in Military Medicine and Surgery of the 
First Pan-American Medical Congress, Washington D. C. t Sep- 
tember, 7, 1893. ' • 

Intercourse with a considerable number of surgeons — those who 
reside in the centers of prothetical industry as well as those who 
inhabit more remote parts — discloses either a limited knowledge of, 
or a diversity of opinion on, the subject of amputations when viewed 
in the light of prothesis. 

In consequence of this unfortunate absence of concerted thought and 
knowledge, artificial limb^makers have frequently brought to their 
presence stumps that are good, bad, and indifferent; stumps that 
could have been better; stumps that reflect credit, discredit, and no 
credit on the surgeons who performed the amputations, or on those 
who attended to them after the amputations were performed ; stumps 
that can readily be inserted into artificial limbs with the assurance 
that no trouble will follow, and that the possessors will live in the sub- 
lime consolation of having realized the removal of their disabilities for 
all practical purposes ; stumps that might have been better and would 
have been beyond criticism, had the operators taken advantage of 
opportunities which familiarity with prothetical methods would have 
revealed to them. 

The time has arrived when this subject should receive more thought, 
and when prothetical knowledge should be more widely disseminated. 

We can see in the not very distant future the subject of prothesis 
embraced in the curricula of the schools and colleges of surgery, when 
a graduate will be equipped with all the information requisite to guide 
him to not only amputate properly, but to put the stump in the most 
favorable condition for the prothetician; to take measurements, dia- 
grams, and casts (when necessary) to enable his patient to obtain a suit- 
able appendage with the least delay; when his knowledge will enable 
him to detect defects in adjustment, and to remove them ; to prescribe 
alterations that may be required to accommodate changes that may 
have taken place in the stump. 

As surgeons will always be more numerous than leg-makers, it is all 
'the more important that their information on this subject should 
be broad, thorough, and correct. 

We shall discuss the subject of Amputations Prothetically Considered 
from but a few standpoints, confining our views to amputations of the 
lower limbs only. 

I. Length of Stumps— Any stump that is well covered with integu- 
mentary tissue cannot be too long. We are well aware that when we 
advance this proposition, we antagonize the views of those artificial 

317 



318 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

■ — — —— — — ■ • ■ 

limb-makers who have not kept abreast of the times, and that we are 
controverting the rules that have been laid down by some writers of 
repute on the subject. 

Artificial limb-makers not many years ago, almost to a unit, decried 
-the amputation of a leg below the junction of the lower and middle 
third, or "the point of election,'' so called, and were pronounced in 
their utterances against all ankle and partial foot amputations. 

The methods which were then employed produced artificial legs that 
were not capable of adaptation to long stumps, particularly to stumps 
that extended to the ankles or below the tarsus. We may add that 
those adverse opinions on long stumps are still held by some protheti- 
cians, notwithstanding the fact that great departures have been made 
during the past, decade or two in prothetical methods. Hence, when a 
leg-maker of modern times says that an amputation should not be 
made below the point of election, you may regard him as confessing 
that he is behind the times, and has not the ability to make a leg that 
can be" worn on a long stump. 

Artificial legs are made at the present time that can be worn on 
stumps of any length, — tibio- tarsal, medio-tarsal, and tarso-metatarsal 
not excepted, — and it can be asserted that any stump that is capable of 
bearing weight on the extremity is preferable to one that cannot. A 
tibio-tarsal amputation made after the method of Mr. Syme produces 
an end-bearing stump, and can be placed in the category of " the most 
favorable." An amputation after Dr. PirogofTs method is also pro- 
ductive of an end-bearing stump, provided the os-calcis is properly 
placed and united to the tibia, or securely held in the inter-malleolar 
space. An amputation in the tarsus, or at the tarso-metatarsal junction, 
after any of the methods of Chopart, Lisfranc, Hancock, or Hey, is 
productive of a stump that is capable of excellent prothetic treatment. 

In every partial foot amputation, care should be exercised to pre- 
vent the contraction of the tendo Achillis ; usually lashing in a suit- 
ably contrived splint will suffice. If this means will not accomplish 
the object, either tenotomy or fixation of the ankle-joint should be re- 
sorted to, for if the heel is allowed to retract and the amputated surface 
point downwardly, the possessor of that stump will be obliged to have 
an artificial leg applied that will not touch, but that will shield the 
amputated surface ; this means that the artificial leg will elongate that 
side and necessitate the wearing of a thick sole and heel on the shoe 
worn on the companion foot. Such a stump ceases to be an end-bear- 
ing one, and its disadvantages are apparent. 

Those modifications of Chopart's and Pirogoff's operations that do 
not provide' flaps on which the weight of the subjects can be endured, 
tax to 'the uttermost the skill of the best prothetician. A case was 
brought to our attention some years ago, which we can opportunely 
refer to here. A young man, a farmer by occupation, residing in Ver- 
mont, had his foot crushed. Amputation was deemed necessary. A 
modification of Chopart's operation was performed. The stump that 
resulted presented the appearance of an inverted cone, the apex scant- 
ily covered with tissue and extremely sensitive. This stump was hope- 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITT. 319 

lessly an end-bearing one, and had to be treated the same as if ampu- 
tation had been made above the ankle. It is obvious that inasmuch as 
a Chopart's operation could not have been performed, a Pirogoff's or a 
Syme's, or even an amputation above the ankle, would have given the 
patient better results. 

The advantages of a totally or partially amputated foot, producing 
an end-bearing stump, over a leg amputation are many. The more 
important are the following : 

First. An artificial leg for an ankle or partial foot amputation costs 
only half the standard price of an artificial leg for an amputation above 
the ankle. 

Second. An artificial leg for any of the above end-bearing stumps 
does not incase as much of the leg and thigh as an artificial leg for an 
amputation above the ankle. 

Third'. A person with a stump extending to the ankle can improvise 
a sheath with suitable pad, on which he can rest his stump and walk 
tolerably well; or, if his stump extends to the metatarsus and a portion 
of the foot remains, he will be able to get about very well without any 
contrivance. These are vital considerations for the poor man, and 
should be regarded by the surgeons. 

The most modern and improved artificial legs for ankle and partial 
foot amputations provide phalangeal support. This is conceded as 
absolutely necessary to aid progression and prevent limping. The 
absence of phalangeal support is always felt by those who do without 
prothetic assistance. 

During the past few years we have personally superintended the 
construction and application of many hundred legs designed for tibio- 
tarsal, medio-tarsal, and tarso-metatarsal amputations. During the 
existence of the house of A. A. Marks, over eighteen thousand subjects, 
with amputations at various points of leg, thigh, and arm, have been 
supplied with artificial limbs. With this experience we feel competent 
to say that long stumps with ample flaps, that stumps resulting from 
tibio-tarsal, medio-tarsal, and tarso-matatarsal amputations, can be sup- 
plied with artificial legs that will be comfortable and pleasant to wear, 
and that will restore the wearers to the amplitude of their usefulness. 

A stump extending below the knee is preferable to a stump extend- 
ing to the knee, provided the stump is capable of flexion and extension. 
If the stump is disposed to become extended and anchylosed, it will be 
preferable to sacrifice the leg to the knee. 

We had occasion to share the regrets of a subject that was brought 
to our office not many years ago. This man's leg had been ampu- 
tated about four inches below the knee articulation. The stump was 
extended and anchylosed. To make an artificial leg for him would 
necessitate a rigid knee in the artificial or an articulated knee out of 
parallelism by about four inches with the natural knee. Either would 
place the fellow at a disadvantage, especially when sitting. If in the 
amputation of this leg the operator had had any indication that his 
patient's stump would have become extended and anchylosed, he would 
have displayed greater wisdom if he had amputated through the knee 



320 A. A. MAEKS, AETIFICIAL LIMBS, NEW YOEK CITY. 

articulation. Any amputation below the knee should, as far as possi- 
ble, be made with proper regard for the preservation of the knee 
mobility, and during the recuperative period the knee should occa- 
sionally be forced into action, so as to prevent impairment of the 
power of flexion arid extension. 

A stump extending to the knee is preferable to a shorter stump. 
The condyles of the femur should never be excised in knee disarticu- 
lations. These nodules afford means for securing an artificial leg, and 
the condyles and articulated surfaces are better prepared by nature to 
endure pressure than the saw or the knife of the surgeon can prepare 
them. 

If the patella can be placed in the inter-condylar space and properly 
secured, it is always desirable to do so. Otherwise it had better be 
removed. 

The foregoing, we hope, will serve as an appeal to every operating 
surgeon to sacrifice as little of the human limb as possible, giving a 
proper regard to the securing of integumentary tissue for the purpose 
of covering the extremity and protecting "the partly excised bones. 
These are certainly the teachings of the wisest and most conservative 
surgeons of the past, and we know of no reason why they should now 
be relegated to obsolescence. 

II. Flaps. — All stumps should be provided with ample flaps, not 
redundant flaps. A redundancy of tissue on the extremity of a stump 
is no advantage. The prime office of flaps is to protect the extremity 
of the bones, and they should be only ample to effectually perform 
that function. Whether the flaps are anterior or posterior, exterior or 
interior, or a combination of the four, it matters not so long as the 
extremities are well protected. Periosteal flaps are desirable, as they 
give additional protection to the bones, and prevent integumentary 
flaps from becoming adhered. 

If an amputation is to be made below the middle third of the leg, 
bone should be sacrificed in order to obtain flap. If the amputation is 
to be made above the middle third, bone should not be sacrificed. 
Every inch of healthy bone above the middle third is desirable for 
leverage purposes. If a thigh amputation is to be made close to the 
knee, bone can be sacrificed in order to secure flap. The nearer the 
amputation is to be made to the body, the greater should be the care to 
save bone. 

III. The Location of Cicatrices. — The rules established by all the 
accepted authorities on ankle and partial foot amputations should be 
rigorously observed in the matter of cicatrices. By so doing the cica- 
trices will be placed in the most advantageous locations for prothetical 
purposes. 

In all amputations in the leg, thigh, or knee, the cicatrices should 
as far as possible be placed well away from the extremities, preferably 
along the posterior aspects. Adhesion or even contiguity of the cica- 
trix with the extremity of a bone is frequently the cause of suffering. 

IY. Treatment of Stumps after They have Become Healed. — A stump, 
before it is called upon to operate an artificial limb, is an inactive rem- 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 321 

nant of an active member of the body. On account of its inactivity, it 
becomes disposed to accumulate adipose tissue, and, if permitted to do 
so, it will become abnormally large and cedematous. If possible, this 
condition should be prevented by tight bandages. Bandages should 
be applied from the time the stump has healed until the artificial limb 
is applied. They should be as tightly drawn as possible and not inter- 
fere with circulation. They should be applied in the usual way, 
beginning at the extremity of the stump, and continued the entire 
length of the complete section of the limb above the stump. This 
means for a partial foot amputation that the bandages should be carried 
to the knee, and for a leg amputation that the bandage should be 
carried to the body. 

We have frequently met surgeons who incline to the belief that an 
attenuated stump should not be allowed ; on the contrary that it should 
be encouraged to grow so as to possess the dimensions of the companion 
leg before an artificial limb is applied. This certainly would be desir- 
able if such growth would permanently and effectually resist the 
influence of an artificial leg to reduce the stump. 

It can be stated for a certainty that an artificial leg will harden, 
solidify, and diminish any stump. In consequence of this, it is 
desirable to keep the stump as small as possible so as to minimize 
the changes that will follow the application and wearing of a leg. 

- V. Time to Apply an Artificial Leg — It will be safe to apply an 
artificial leg to a stump that has resulted from traumatic causes as soon 
after the healing of the stump and the patient has recovered from the 
shock as possible. Nothing can be gained by waiting beyond that time. 
Waiting entails a loss of time and permits the stump to become ener- 
vated from disuse. 

A stump that is the result of disease, especially if of a malignant 
nature, should be obliged to wait until there is a certainty that the 
pressure, confinement, and concussion that follow, more especially 
the initial operations, will not cause a recurrence of the disease. 

A child who has lost a leg is never too young to have an artificial 
one applied. It should be observed that the tissues, bones, and articu- 
lations of an infant or a growing child must be forced into repeated 
action in order to become developed, healthy, and vigorous. 

To hobble about on one crutch or a pair of crutches for a number of 
years is rather a severe and inhumane punishment to impose on a child 
because he is growing. An artificial leg of modern construction can be 
lengthened from time to time at a very slight expense, and, as it pro- 
vides the nearest approach to a natural prop for the amputated side, 
it is the only means that will encourage healthful growth and sym- 
metrical development. 

To illustrate this fact, we can do no better than present the case of 
an infant brought to us by Dr. Bacon of New Haven, Conn. The 
child was not quite nine months old when we took her in charge. 
Her leg had been amputated two inches below the knee for congenital 
deformity. The stump tended to flex and remain so; anchylosis was 
feared. We applied a neat-fitting leg with knee articulatiou. It 



322 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

held the stump in extended and flexed positions, according to the 
manner in which the child was held or placed. In a few months 
the child began to creep, a few months later she was able to stand, and 
later still she learned to walk. The artificial leg assisted her in all these 
stages of progress. She developed rapidly and symmetrically, and to- 
day she is a young lady of comely proportions, enjoying good health, 
walking as gracefully as one in possession of nature's limbs — a testi- 
mony of the wisdom of applying artificial limbs to the young when 
misfortune has deprived them of their share of extremities. 



In the summer of 1893, George M. Sternberg, M. D., Surgeon Gen- 
eral of the United States Army, and Executive President of the Section 
on Military Medicine and Surgery of the Pan-American Medical 
Congress, invited us to read a paper on "Amputations Viewed by an 
Artificial Limb-Maker," before the Congress. 

We esteemed the compliment on account of the eminence of its origin, 
and felt that an opportunity had been presented which we should not 
allow to slip; that of presenting to the profession some deductions on 
amputations which we had made in the prosecution of our profession. 
The foregoing paper was hastily prepared and read before the Pan- 
American Medical Congress in Washington, D. C, on the 7th of Sep- 
tember, 1893. Subsequently it was published in the New York Medical 
Journal and other medical periodicals. 

It should be noted that the essence of the paper approves of the con- 
servatism of the older authorities in sacrificing as little of the human 
body as possible, depending upon the willingness, ingenuity, and skill 
of the prothetician to substitute that which has been removed. The 
failures of many protheticians in devising desirable substitutes for long 
stumps have caused some to utter voices of condemnation on amputa- 
tions that admit of stumps extending below the " point of election," 
claiming that such stumps were ill-suited for the wearing of artificial 
limbs, and therefore should not be made. We hope the foregoing paper 
will successfully controvert that fallacy. 



THE RELATION OF SURGERY TO PROTHESIS. 

Surgery is that branch of medical science that treats of manual 
operations for the healing of diseases or injuries of the body. Pro- 
thesis is the addition of an artificial part to supply a defect of the 
body. These sciences are correlative : what surgery cures by remov- 
ing, prothesis restores by artificial means. 

The close alliance of these sciences should compel close intimacy 
between the surgeon arid the prothetician, and each should be ac- 
quainted with the methods of the other. If the surgeon is void of all 
knowledge of prothesis, his ignorance is likely to blight the prospects 
of his patient. If the prothetician is void of all knowledge of anatomy 
and physiology, which form the basis of the surgeon's art, he cannot 
help but blunder in the prosecution of his work. He may construct 
artificial limbs scientifically, but if he fails to fit and adapt them prop- 
erly, his labors will bring disappointment. His knowledge should 
enable him to detect any abnormal condition of bones, nerves, muscles, 
or tissues, whether congenital, strumous, or otherwise, and his skill in 
adapting the artificial limbs should enable him to provide against the 
aggravation of malignant conditions. 

Prothesis is the child of surgery. Ambrose Pare, the most distin- 
guished surgeon of the sixteenth century, drew the plans, superintended 
the construction, and personally applied the artificial limbs that were 
worn by his patients. The science, however, did not remain long in the 
realm of surgery. Immediately after Pare's time it became an industry 
by itself and drifted into the shops of obscure mechanics, and it is 
not surprising that for over two centuries it lost its importance, 
and not until recent times has it displayed sufficient life to command 
the attention of its legitimate parent. 

Surgeons are becoming more familiar with prothetic methods, and 
are giving more intelligent thought to the future welfare of those 
from whom they have removed diseased or mangled limbs. 

The present is the beginning of an era in which prothesis'is to be 
recognized as a successive stage of surgery, entitled to the dignity it 
deserves, and when this is fully realized there is bound to be less con- 
fusion among the surgeons and greater unity among the protheticians. 

Surgery must lift prothesis to a higher level, and prothesis must do 
its part in directing the labors of the surgeon. 

The opinions and prejudices of inexperienced makers must never be 
permitted to have an influence. When the surgeon expresses an 
opinion on the subject of prothesis that is not his own, he must be 
supported by some authority more significant than a self-opinionated 
leg-maker whose arrogance is more conspicuous than his research is 
comprehensive. "We have stood aghast at the audacity of those whose 
power of comprehension is limited, in condemning conservative surgery 

323 



324 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

simply because their ingenuity was too limited to enable them to 
construct limbs that were adaptable to long end-bearing stumps, which 
older and more experienced manufacturers have looked upon with 
favor for years. 

Incalculable evil comes from the shops of incompetent manu- 
facturers, and especially from those that have met with enough suc- 
cess to encourage their self-importance, but not enough to command 
the position of authority. Prothetic quacks are responsible for much 
of the misery that comes to the maimed. They ruin good stumps, 
convert lives which have the promise of comfort and relief into lives 
of pain and anguish, by foisting their crude experiments upon the 
credulous. The surgeon should look with disdain upon these charla- 
tans. We cannot help feeling that the time is ripe for the legislatures 
of the States to take the matter in hand, and legalize only those who 
are competent and qualified — the welfare and protection of the maimed 
demand it. 

There must be less diversity of methods, more genuine study, and 
less experimenting ; artificial limb-makers must be made to agree on 
many essential points at which they are now at variance ; rules must 
be established regulating the fitting and adjusting of artificial limbs, 
which when well established will make the. lines of procedure so 
definite that the limb-wearer will be subjected to less experiments and 
be served in a more humane manner. 

The schools of medicine and surgery should add to their curricula 
the subject of prothesis, and every student should be instructed 
to the extent that he will know where to amputate, how to treat the 
stump after it has healed, how to take measurements from which 
artificial limbs are to be constructed, how to apply and adjust limbs 
after they have been delivered, and watch the cases and know what 
to do when changes have taken place in the stumps, and above all, he 
must be instructed so as to distinguish between the proper and the 
improper methods of fitting. There is to-day no text-book upon the 
subject whereby the student can be tutored upon advanced American 
methods. Some years ago European writers placed in their books the 
ancient methods of German, French, and English manufacturers, such 
as Bechard, Mathieu, Charrier, Biggs, and incidentally referred to 
Palmer, Bly, and Marks. All the literature on this matter that we 
have seen has been ancient, foreign, vague, and desultory. . 

The prothetic knowledge of the surgeon at the present time is noth- 
ing more nor less than the opinion of the limb-maker whom he has 
chanced to meet : which is as likely to be misleading as it is to be 
reliable. Among the limb-makers there is no harmony. Every maker 
has a peculiar line of operation for himself, and most of them will 
sacrifice much rather than deviate from these lines. As long as this 
state of affairs exists, the unfortunate man who has had his leg or arm 
removed can neither obtain comfort from his surgeon nor feel assured 
that in selecting his limb-maker he has been judicious. He is cast 
upon the sea of doubt, and is just as likely to drift into the hands of 
the charlatan as he is into the haven of science and skill. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 325 

Education is needed, and legal protection should be granted. No 
man should be permitted to construct artificial limbs until he has given 
evidence of his fitness. The laws of the State and the country should 
be as rigid in licensing prothesists as they are in licensing dentists. 
A few years ago anybody could hang out his shingle and pull and fill 
teeth. After a number of jawbones had been broken, and great 
damage done to the faces and mouths of the victims of quackery, the 
law took the matter in hand and permitted none to practice dentistry 
until they had given evidence that they had been properly schooled 
and were thoroughly competent. It must be the same with artificial 
limb-makers, and we will hail with joy the time when the cripple will 
be protected by law the same as the man with a diseased or aching 
tooth. 

One of the objects of this book is to present as many phases of stumps, 
and the manner in which they have been prothetically treated, as 
possible, and in this respect we hope and anticipate that this book will 
do some educational work. 

In addition to what has been offered we desire to pass a few obser- 
vations that bear more directly upon amputations and the treatment 
of stumps, and we will confine ourselves to the consideration of the 
subject under the following headings : 

Length of Stumps. — The rule "of amputating with the least sacri- 
fice," established by surgeons of the past and observed by conserva- 
tive surgeons of the present time, is golden ; and when one condition 
is imposed, it can be safely used to govern the surgeon in selecting 
a point at which an amputation should be made, in every case, whether 
foot, ankle, leg, thigh, or arm, and that condition is as follows : no 
amputation should be made below a point at which a good integu- 
mentary flap can be obtained. Bones must be protected by tissue in 
order to escape dangers that threaten every stump, and no stump can 
be too long, provided the end is covered by ample flap. 

Flaps. — Before the knife is applied to a diseased or mangled limb, 
careful examination should be made of the tissues, and the amputation 
should be made at a point where dependence can be placed upon 
obtaining sufficient healthy tissue to form an ample flap. Imperfectly 
nourished or lacerated tissue can never be depended upon. The absence 
or impairment of the nutrient vessels will invite sloughing, and it is 
doubtful that any antiseptic treatment will prevent the decay. It is 
far better to sacrifice bone than to sacrifice flap. 

Anterior flaps are usually preferable, but it matters little whether 
flaps are anterior, posterior, or lateral, or whether the operation is cir- 
cular in all short and non-end-bearing stumps ; but in all long stumps, 
and particularly end-bearing ones, the flaps should be either anterior or 
posterior, and sufficiently long to not only cover the stump, but to place 
the cicatrix well away from the end. 

Cut No. 1126 is an outline of a long leg stump. The amputation was 
made immediately above the maleoli. It proved to be an ill-advised 
place. Anterior and posterior flaps were brought to the bottom of the 
stump and sutured laterally across the extremity ; as the tissues sur- 



326 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



rounding the ankle were seauty, the flap could not be abundant. The 
cicatrix was placed at the most unfortunate part of the stump. The 




No. 1123. 

subject would have fared better if the amputation had been a few 
inches above, and a long anterior flap obtained and carried to the rear. 




No. 1127. 



Cut No. 1127 represents a stump extending to the ankle. A circular 
operation was performed, and as the flaps were either unhealthy or 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



327 



insufficient, the tissues retracted during the healing period and the t 
fibula, which was permitted to remain a little longer that the tibia, 
became exposed and cicatrized. This was an unfortunate stump, the 
extremity being irritable and rebelling against any contact, pressure, 







or the slightest contractile force. A secondary amputation was found 
necessary after a few years of suffering. 

Cut No. 1128 represents amputations of both legs just above 
the ankles. If more care had been given to the obtaining of flaps 
than to obtaining long stumps, the patient would have fared much 
better. The patient was injured by the railroad cars; both feet were 




No. 1129. 

crushed and the tissues lacerated. The amputations were performed as 
close as possible to the seats of injury; flaps were formed of lacerated 
tissue, and the most rigorous antiseptic treatment was followed. Both 
stumps sloughed, and when they became healed their extremities were 
covered by cicatrical tissues. Although the subject is an active business 
man and walks remarkably well on a pair of artificial legs, there is 
hardly a doubt that at some future day secondary amputations will 
have to be performed. The stumps at times swell and are very sensi- 



.328 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



,tive to heat and cold, and the imperfect manner in which they are 
nourished causes much suffering. 

Cut No. 1129 represents an amputation close to the ankle, the 
extremity large and irritable. The artificial leg that receives the 
stump is necessarily large and clumsy, and the absence of healthy flap 
on the end of the stump is the cause of much suffering. 

We very rarely find a stump that reaches to any point between the 
junction of the lower and middle thirds and the maleoli that is pro- 
vided with an accommodating flap. The natural leg between those 
points is so scantily covered with tissue that it is difficult to find 
material from which a healthy flap can be formed. For .these reasons 
we are fully persuaded that it is better to amputate at the point of 
election than close to the maleoli. 

Ankle Joint and Partial Foot Amputations.— Amputations through 
the ankle articulation, or through the tarsus, produce commendable 





No. 1130. 



No. 1131. 



stumps, provided good flaps are obtained and cicatrices are well away 
from the weight- bearing surfaces. Extreme care must be given in these 
operations to prevent the retraction of the tissues and the contraction 
of the tendons, for when a stump fails to become an end-bearing one, 
the purposes of retaining so much of the limbs are defeated. 

Cut No. 1130 represents an amputation through the metatarsals; the 
operation was successful and the stump that resulted was beyond 
criticism. An artificial foot was applied, which has been worn for many 
years without causing pain, or subjecting the wearer to any incon- 
venience. 

Cut No. 1131 represents an outline of a tarso-metatarsal amputation, 
after Chopart's method ; the operation was skillfully performed and the 
results gave the surgeon much gratification. The subject has for a 



A. A. MAEKS, ARTIFICIAL LIMBS, NEW YOEK CITY. 



329 



number of years walked on a rubber foot in a very natural and com- 
fortable way, and is engaged in a laborious occupation. 






No. 1132. 



No. 1133. 



No. 1134. 



Cuts Nos. 1132, 1133, and 1134 represent ideal stumps resulting from 
tarso-metatarsal amputations. 

Retracted Heels and Contracted Tendo-Achillis. — When an ampu- 
tation is performed in the foot, constant vigilance must be given 






No. 1135. 



No. 1136. 



No. 1137, 



to the disposition of the plantar surface, that it remain in its proper 
place, and also to the condition of the tendo-Achillis. Greater 



330 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



care must be given to this matter if the amputation has been made 
above the insertion of the flexors ; if there is a disposition on the part of 
the tissues to retract, or on the part of the tendon to contract, some 





No. 1139. 





No. 1141. 



opposition must be offered, and if this fails, tenotomy should be 
performed. 

If the contraction is but slight, no serious trouble will follow; but if 
it is considerable the difficulties of fitting and adapting artificial feet 
will be greatly multiplied. 

Cuts Nos. 1135, 1136, 1137, 1138, 1139, and 1140 are stumps resulting 
from partial foot amputations. During the healing periods the heels 






No. 1143. 



No. 1144. 



were permitted to slightly retract, but the retractions were not so great 
as to bring the amputated surfaces to the ground, or to make it impossi- 
ble for the maker to adapt the limbs so as to bear comfortably on the 
ends and to prevent further retraction. 



A. A. MAEKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



331 



Cuts Nos. 1141, 1142, 1143, and 1144 represent stumps resulting from 
partial feet amputations, the heels retracted, and the tendons contracted 
so as to make the stumps non-end-bearing. Artificial limbs applied 
to these cases were not permitted to bear upon the extremities ; they 
extended nearly to the knees, and received bearings immediatelybelow 
the knees. 

Cut No. 1145 represents a partial foot amputation necessitated by 
gangrene of the toes and front part of foot; the heel became retracted, 




and the case was a very difficult one for the limb-maker. The appli- 
ance had to cover the leg to the knee, and take support immediately 
below; the lower part was necessarily very large. It is evident that 
an amputation considerably above the ankle would have given this 
man much better results. The comment of a prominent surgeon 
was that " There is no justification in undertaking a Chopart's oper- 
operation for a gangrenous foot; sloughing is sure to follow, and the 
recurrence of gangrene is more than likely." 

Cuts Nos. 1146 and 1147 represent partial feet amputations. The 
operations were performed through the astragalus. The extremities 
were only covered by cicatrized tissue. These are the most unfortu- 
nate types of partial feet amputations. It would have been far better 
if each amputation had been made through the ankle articulation. 

Cut No. 1148 represents a stump resulting from PirogofTs operation. 
The os-calcis became slipped from the inter-malleolar space, but not- 
withstanding that fact, the stump became firm and strong and capable 
of excellent prothetic treatment. 

Cut No. 1149 represents a PirogofTs amputation, with the os-calcis 
properly placed and adhered. The stump is beyond criticism, and 
capable of enduring any hardship. 



332 



A. A. MAEKS, ARTIFICIAL LIMBS, NEW YOEK CITY. 



Cut No. 1150 is an outline of a typical Symes 1 stump, an ideal one, 
capable of the most excellent prothetic results. 




No. 1146. 





No. 1148. 



Cut No. 1151 represents an outline of an ankle joint amputation. 
Two flaps were formed from the sides and brought together and sutured 
from the front to the back; the stump was not capable of bearing 




No. 1149. 





No. 1151. 



pressure upon the extremity. If the flap had been from the rear and 
sutured laterally across the front the stump would have been an end- 
bearing one. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



333 



Cut No. 1152 represents an amputation through the ankle joint for 
the removal of a club foot — talipes valgus. The operation was com- 
mendable, and the subject was greatly benefited ; a flap was carried from 




No. 1152. 





No. 1154. 



the interior side and sutured on the exterior side a little above the end- 
the stump was capable of bearing pressure upon its extremity. 




Cut No. 1153 represents an amputation through the calcaneum, to 
remove club foot— talipes equinus. Good results followed. The stump 
was capable of bearing pressure upon the extremity, and the patient was 
greatly improved by the operation and benefited by the artificial limb. 

Cut No. 1154 represents a stump resulting from an amputation to 



334 



A. A. MARKS, ARTIFICIAL LIMBS, NEW TOEK CITY. 



remove a deformed foot; the extremity was naturally cushioned, and 
the subject became very expert in the use of an artificial leg. 
Cut No. 1155 represents an amputation to remove a deformed right 





foot which proved successful in every respect. The patient was born 
with both feet deformed; he was able to sustain his weight upon the 
left foot, but could bear no pressure upon the right. The right foot 




No. 1158. 

was amputated at the ankle, and an excellent stump was produced. 
An artificial leg was applied and the subject restored in a most corn- 
plete manner. 
Redundant Flap&. — We have endeavored to emphasize in the 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



335 



strongest possible manner the importance of providing every stump 
with an ample flap. We do not wish to be construed as inferring that 
there cannot be too much flap; on the contrary, a redundant flap is 
objectionable, as it is always the cause of much suffering. Soft tissues 
hanging loosely from the end of a stump cannot be placed under con- 
trol. Sockets must be fitted so that the soft tissues will be under 
lateral pressure, otherwise there will be a loss of motion : the bones, 
being surrounded by soft tissue, will move considerable distances 
before they can have any effect on the leg. Redundant flaps are 
always accompanied with deep fissures and large folds of tissue, 
where dirt and perspiration collect and cause irritation. 

Cuts Nos. 1156, 1157, and 1158 represent tibial stumps with redund- 
ant flaps. Soft tissue hangs below the extremities and flops about in 
the sockets, frequently becoming displaced and troublesome. 

Extended and Ankylosed Stumps. — If there is any indication that 





No. 1159. 



No. 1160. 



the knee motion will become permanently impaired, and an amputa- 
tion is to be made above the ankle, it will be advisable to amputate 
through the knee. A stump below the knee extended and ankylosed 
as represented in Cuts Nos. 1159 and 1160 is unfortunate. Although a 
leg can be applied that will enable the wearer to walk very naturally, 
it will not be possible to correct the long protruding thigh, so conspicu- 
ous when the subject is seated. The knee-joints of the artificial leg 
may be placed in their proper positions, so that they will work on lines 
with the sound knee, and when the wearer is seated the artificial leg 
will bend so that the foot will remain on the ground, but the stump 
which is stiff will protrude beyond the natural knee, and be in the 
way. A part of the tibia, although well covered with flap, can be of 
no benefit when the knee is ankylosed. 

If there is limited motion in the knee, and there is a possibility of 
improvement, and a good flap can be obtained, it is well to save the 
knee and as much of the leg as possible. 



336 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



Cut No. 1161 represents a tibial stump at its fullest extension, and 
cut No. 1162 represents the same at its greatest flexion. It will be 
seen that the range of motion is less than twenty-five degrees. An 




No. 1161. 



No. 1162. 



artificial leg with knee articulation was applied to the case above illus- 
trated, and in a comparatively brief time full knee motion was restored. 
The results in this case justified the amputation of the leg at the point 
indicated in the cuts. 





No. 1163. 



No. 1164. 



Deflected Tibial Stumps. — We occasionally find tibial stumps that 
appear to be abducted at the knee, a condition that is found to be a 
source of anxiety to the surgeon as well as to the patient. 

Cut No. 1163 represents a deflected tibial stump. The fibula has 
become deflected outwardly, and the tibia appears to have become 
abducted at its articulation. A careful examination of a nurn^erof 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



337 



stumps of this character have satisfied us that no abnormal conditions 
exist in the articulating parts. The knee motion is generally perfect, 
and articulation is not attended with pain or unusual consequences. 
The interior aspect of the leg has, by atrophy, become scantily covered 
with integumentary tissue ; this, with the deflection of the fibula, pro- 
duces the apparent abduction of the knee. The condition is neither 
troublesome to the limb-maker nor unfortunate to the patient, as arti- 
ficial limbs can always be adjusted with good results. 

Anomalous Flaps.— Cut No. 1164 represents a tibial stump, right 
side, with the entire fibula removed, and the tissues permitted to form 




No. 1165. 

great folds on the exterior side. A cicatrix runs longitudinally from 
the end of the stump to the knee. The surgeon who performed this 
operation was in doubt as to the justification of retaining the tibia when 
the fibula had to be removed ; fortunately the operation did not impair 
the knee movement, and as the tibia was strong and powerful, it could 
be depended upon in performing the work of flexing and extending the 
artificial limb. An artificial leg was applied, and the patient walked 
naturally and comfortably, and has worn it for a number of years 
without occasion for complaint. 

Cut No. 1165 represents a tibial stump, the amputation being per- 
formed a little above the middle of the gastrocnemius muscle. During 
the healing process the muscles retracted, and the tissues about the 
extremity became puckered at the rear. Although this condition gave 
some alarm, the case was not found difficult for satisfactory prothetic 
treatment. 



338 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



Cut No. 1166 represents a tibial stump. The operation was performed 
to remove a leg that had been badly burned ; the amputation was per- 
formed at the juncture of the middle and upper thirds, the flaps were 
formed of scarified tissues, and consequently were irritable ; advantage 
was taken of a few isolated bearing places, and a limb was applied. 
Three inches of this stump could have been removed to advantage. 

Knee Disarticulations. — Amputations through the knee joints are 
not condemnable, notwithstanding the fact that many artificial limb- 
makers look with disfavor upon them. 

In knee disarticulations every effort should be made to produce end- 
bearing stumps ; this can only be done by allowing the natural cover- 




No. 1166. 



ings on the articulating surfaces to remain untouched, or to provide 
covering from periosteal and integumentary tissues, bringing the 
cicatrix well away from the extremity. If an end-bearing stump can- 
not be obtained in a knee disarticulation, it will be better to amputate 
at about the juncture of the middle and lower thirds of the thigh, and 
get rid of a sensitive extremity that cannot be of any use. 

Cut No. 1167 represents a knee-joint stump, rear view. The patella 
and external condyle were removed ; the internal coudyle was preserved 
in its entirety; the flap was brought to the rear and the cicatrix well 
removed from the extremity.' An artificial leg was applied so that 
pressure was placed directly upon its extremity, where it was endured 
without annoyance. 

Cut No. 1168 represents a knee-joint amputation, the sides of the 
condyles removed, the flap carried over the extremity, the cicatrix 
placed at the rear and well away from the end. Weight was applied 
directly to the . extremity and endured without suffering. In con- 



A. A. MAEKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



343 



is that the muscles will waste, and by the process of substitution the 
stump will become fat. When the stump is put to use. in controlling an 
artificial leg, the tissues are compressed by the socket, the stump is 
forced into activity, the hypertrophied tissue will waste, and adipose 
tissue will be prevented from forming by the pressure of the limb. 
For these reasons stumps that are obliged to work become atrophied, 
and those that remain idle become hypertrophied. 

Cut No. 1174 represents a tibial stump that has been used to control an 
artificial limb for a number of years. The stump is atrophied and there 
is very little tissue about the bones; notwithstanding this fact the sub- 




No. 1174. 



ject is a well-developed, strong, and healthy man. With an artificial 
leg, well fitted, he performs the work of a laborer, and never suffers 
from abrasions. 

Cut No. 1175 represents an atrophied thigh stump. As shown in the 
cut, the stump is very much smaller than the sound thigh. The wear- 
ing of an artificial leg for a number of years has caused this emaci- 
ation. Atrophy does not cause any annoyance or inconvenience, as 
the subject wears an artificial limb constantly and without suffering. 

It cannot be stated that all stumps will atrophy, any more than it can 
be stated that all stumps will hypertrophy. Many remain the same 
size for years. A person who is disposed to grow fat will carry that 
disposition to his stump, and it will either hypertrophy, or maintain 
its normal dimensions, and a person who is naturally lean will find 
that his stump will remain thin, or will atrophy. 

There are exceptions to these rules. We know of fat men who have 
atrophied stumps, but they are in the minority; and we know thin 



344 



A. A. MAEKS, ARTIFICIAL LIMBS, NEW YOEK CITY. 



persons whose stumps have never atrophied, but as so many stumps 
follow the rules above enunciated, it is a wise plan to take them for 
criteria. Therefore all stumps should be bandaged, and kept band- 
aged until artificial limbs are applied. By this means all possible 
changes will be minimized. 

Bearings.— The places at which a stump can take pressure and sus- 
tain the weight of the wearer, when an artificial limb is in use, should 




/ M 




No. 1175. 



No. 1176. 



be understood. The surgeon, in many cases, has it in his power to 
establish and locate those places, and with a knowledge of prothetic 
methods his work in that direction should be facilitated. 

An end-bearing stump is always desirable. Disarticulations in the 
ankles or knees, or partial foot amputations, can usually be depended 
upon in producing end-bearing stumps, and unless some disease of the 
tissues, flaps, or bones exist, and unless some neurological complica- 
tions are present, those stumps are not disappointing. 

Amputations between the articulations, or through the shafts of the 
bones, seldom produce end-bearing stumps. Non-end-bearing stumps 
must receive bearings about 'the enlarging parts immediately above the 
extremities. This means that a non-end-bearing stump below the knee 
must receive pressure on the interior, anterior, and posterior surfaces 
immediately below the knee. The styloid process of the fibula is 
always close to the surface and is surrounded by sensitive tissue and 
is painful to continuous pressure; therefore, the exterior surface must 
never be permitted to bear pressure. 

Tibial stumps that are well covered with periosteal and integu- 
mentary tissue can receive pressure on their ends, but these stumps are 
extremely few. 

A thigh stump will never admit of weight being applied to its 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



345 



extremity, unless the end of the femur is covered with a periosteal flap 
and that in turn well covered and protected by an integumentary flap 
with the cicatrix well removed. 

An artificial leg applied to a thigh stump takes weight about the 
ischial and perineal regions, where the gluteal folds provide natural 
cushions. 

Cut No. 1176 represents a thigh stump. It is held horizontally in 
order to show the mobility of the hip. The flap, as will be seen, is 




No. 1177. 



well carried to the rear and the extremity is well protected. This >s 
a model short thigh stump ; it can be depended upon to perform a vast 
amount of labor. Cut No. 1177 represents a short thigh stump, circu- 
lar operation, with tissues adhered to.the bone. The stump is covered 
with accommodating folds that permit displacement without pressure 
on the cicatrized end. 

Sinuses. — Sinuses in the ends of stumps are sometimes the cause of 
anxiety, as they are stubborn to heal and frequently rebel against treat- 
ment. It is an error to assume that their presence prevents the wearing 
of an artificial limb. While we always condemn the premature appli- 
cation of an artificial leg, we have found when a stump is healed 
with the exception of a sinus, that the wearing of an artificial limb 



346 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



stimulates the circulation, and is frequently the means of causing the 
sinus to heal. The end of a tibial or femoral stump with a sinus is 
never permitted to receive pressure, and when the limb is applied it 
hangs in space ; therefore the presence of a sinus cannot prohibit the 
use of a limb. 

Adhesions. — Every effort should be made to prevent the adhesion of 
a cicatrix with the bone. A stump that has loose and soft media on 
the extremity is capable of more hardship,. Adhesions result from 
sloughing, or the provision of insufficient flap, or the placing of the 
cicatrix contiguous to the bone. They will rarely occur if ample 
(not redundant) flaps are made from healthy and well-nourished tissue 
and carried well over the stump and sutured well away from the end. 

Conical Stumps. — The conical stump has been regarded as the 
"opprobrium of surgery." This term, however, applies only in cases 
where the degree of conicity is very great and the bone is permitted 




No. 1178. 



to protrude from the'end, covered only by adhered cicatrized tissue. 
There are no valid objections to conical stumps when the extremities 
are well cushioned. 

Cut No. 1174, page 343, represents a stump that has become conical 
from atrophy due to the wearing of a limb, but the extremity was suffi- 
ciently covered with integumentary tissue to remove all objections. 

Cut No. 1178 represents a conical tibial stump in which the point of 
the tibia protrudes and is a source of annoyance. We do not infer 
that the surgeon is responsible for this condition, but if there is a 
method of treatment by , which the protrusion of the bone can be 
averted, that method should be understood and practiced, as such 
stumps almost invariably demand secondary amputations sooner or 
later. 

Cut No. 1179 represents a double amputation of right leg immediately 
above the ankle, and of the left well up on the thigh. The right stump 
is conical, but the extremity is well protected. This subject was sup- 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



347 



plied with a pair of artificial limbs, which have been worn for a number 
of years in a most successful and highly gratifying- manner. 
The surgeon must never consider that his work is done as soon as 




the stump is healed; he must carry his art to another stage — he must 
prepare the stump for the artificial limb; he must tell his patient when 
an artificial limb can be applied with impunity ; and he must make no 
error. If he does it will be discovered sooner or later, and unpleasant 
criticisms will be passed upon his skill and knowledge. 



FROM THE STUMP TO THE LIMB. 

The city establishment of the firm A. A. Marks occupies the entire 
building, consisting- of five floors, basement, and sub-basement, of 701 
Broadway, New York City. 

The out-of-city buildings consist of a steam saw-mill and several 
storage buildings, thirty miles distant, located on the western border 




No. 1180.— Wellow Tree in Winter. 



of Connecticut. The number of hands employed in the several depart- 
ments will average over forty. 

It is the object of these pages to take a run through the several 
departments, and follow the making of an artificial limb from the tree 
to the finish, the purpose being to convey to the reader the system and 
thoroughness of detail which enables the house to execute work for all 
the world. 

The adoption of wood in the construction of a leg is empirical, having 
stood the tests that have shown the shortcomings of every other avail- 
able material— rawhide, leather, vulcanite-rubber, celluloid, papier- 
mache, tin, copper, steel, and pulp. Wood possesses strength and 
lightness, rigidity and durability; it does not heat the stump, and 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



349 



retains its virtues for many years. All other known materials lack 
more or less of these qualities. 

There are two kinds of wood that are peculiarly adapted to the pur- 
pose, Willow and Bass. 

Willow or Salix is found in groups on the banks of streams and in 
marshy places ; occasionally the tree is found isolated in a lonely lot. 

This wood has but few uses in the industries; we read of the 
ancients using it for shields, to guard their bodies from arrows and the 
missiles of their enemies. In modern times it is charred for making 
gunpowder, crayons, etc. It is also turned into disks for polishing 




No. 



1181.— Bass- Wood Thee in Winter. 



glass, advantage being taken of its fine and tough grain. As a general 
thing the wood is regarded by the forester as worthless ; in clearing 
his land, he allows it to decay, or burns it in situ. Cut No. 1180 
represents one of these trees, as it appears in nature, when the winter 
has divested it of its foliage, and when the woodman's ax and saw are 
about to fell it for artificial-limb timber. The tree is large, sheltering 
a great area of ground; it has a short, knotty trunk, frequently grow- 
ing to six feet in diameter at the base and ten to twenty feet in height, 
when it divides into many great and far-reaching branches. There 
are many species of willow, most of which are suitable for the 
purpose. 

or linden is a worthy rival of the willow, though it has no 



350 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



botanical relation with it. Cut No. 1181 represents a basswood tree in 
winter; its trunk is straight and smooth, its general form is symmetri- 
cal, its branches forming graceful curves and returning angles. 

Both the bass and willow are native woods, abounding largely in 
New England. The trunks are only used in the art. 

The India-rubber tree is indigenous to Central and South America. 




The gum that oozes from its bruised surface is used in the manufacture 
of the feet and hands of the Marks' patent. 

Knowing what trees to select, we will accompany the woodman to 
the forest, which is likely to occur on a cold, crispy winter's morning, 
with a foot or more of snow on the ground; the company will prob- 
ably consist of a dozen men, with axes, cross-cut saws, steel wedges, and 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



351 



beetles, a powerful team of Normandies, a truck, drags, chains, and all 

the implements necessary for the rapid handling of great, heavy logs. 

As a preliminary, the ax-man will cut away the hedges and clear the 




No. 1183.— Buzz Saw Cutting Artificial Limb Timber. 

way for the sawyers, who will apply the cross-cut saw horizontally 
and as close to the ground as possible. The tree will soon yield and 




No. 1184.— Jig Saw in Mill. 

fall to the ground, where it is cut into logs of suitable lengths, then 
split into sizes by use of wedges and beetles. The truckman piles the 



352 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 




No. 1185.— Timber Stock at Factory. 




No. 1186.— Sock and Supply Room. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



353 



logs on his vehicle and carries them sometimes twenty miles to the 
mills at Sound Beach, Conn. Here the logs are trimmed on a buzz or 
circular saw; the heart, bark, and gnarly parts are removed and 
thrown away. The logs are then taken to the boring machine, where 
an augur of suitable size is driven through their centers. Natural 
crook logs, such as are used in natural crook legs, are trimmed on a 




jig saw, the natural curve of the grain being carefully preserved. The 
timber is then placed in a kiln-dry, which is provided with steam pipes 
covering the floor, from which hundreds of smaller pipes arise verti- 
cally. The sticks, fresh from the mill, with holes bored through them 
longitudinally, are placed on these pipes, where they remain for 
several weeks under the heat of live steam. This ingenious kiln-dry 
was contrived by A. A. Marks, and is used exclusively by him. The 



354 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



effect is to bring a uniform heat to the inside as well as the outside of 
each stick, thus avoiding checks by unequal seasoning. After the sap 
has thoroughly evaporated, which is ascertained by the weight, the 
sticks are taken to a cold, dry, dark storehouse, and there they remain 
for two or more years until they are thoroughly seasoned. They are 
then shipped to'the factory, New York City, and worked into legs and 




arms and sent to all parts of the world. This operation of obtaining 
timber occupies the greater part of every winter. 

The New York shop is a veritable beehive. Passing into the upper 
hall, we find ourselves in the timber room, see cut No. 1185, where dry, 
ready timber is kept in stock. 

Adjacent to this hall is the sock and supply room, cut No. 1186. 
Lamb knitting machines are operated here to meet the demand for 
cotton and woolen socks, which are worn on the patients' stumps. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



355 



Socks are made in any size or shape to conform to the shape of the 
stump. They are seamless and made of the best quality of material, 
either of cotton or wool, and of white or dark color. 

In addition to socks this room is well stocked with webbings and 
suspenders, felt, buckles, oil cans, grease, and everything requisite for 
the wearing of artificial limbs. 




The machinery department is well equipped with every requisite to 
facilitate the correct and rapid production of all the metal parts of an 
artificial limb. 

Cut No. 1187 represents one of the divisions of this department. The 
man at the vise is finishing feet and hands to be used in mold making 
for vulcanizing rubber feet and hands ; the man at the fire is heating 
metal to forge into desirable forms. 



356 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



Cut No. 336 represents another view of the machine room. Here 
presses, lathes, and milling machines are under the management of 
skilled operators. 

The wood shop is provided with band and circular saws, turning, 
boring, and hand lathes, buffing, grinding, facing, and mortising 




machines, all operated by power. Cut No. 1189 represents the shop, 
looking east. 

Cut No. 1190 represents the wood shop, looking to the west. Al- 
though this department is well equipped with machinery, there can 
be but little machine work on an artificial limb. A log can have the 
rough corners sawn off and can be trimmed to an approximate shape 
and size, but it takes the experienced workman to carve it to the grace- 



A. A. MAEKS, ARTIFICIAL LIMBS, NEW YOEK CITY. 



357 



f ul but irregular contours of the natural limb, every leg and arm being 
different in form, size, and character. 




No. 1191. — Band Saw at Factory. 

The eye, the brain, the hand, control the implements that shape the 
outside to match the opposite leg, or excavate the log to fit the stump. 




No. 1192— Carving Outside of Leg. 
The connecting parts of the leg are mortised by a routing machine. 
After the log has been fitted, shaped, and smoothed both inside 



358 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



and outside, it is banded in order to increase its strength to resist 
internal pressure. The leg or arm now passes into the finishing room, 
where a rawhide covering is tightly stretched on the outside, and an 
enamel coating placed on the same. 

The feet are covered with calfskin. During the drying process the 
limb is placed in a room heated to one hundred degrees, the enamel is 
baked, and made to be permanent. 

The leg or arm receives its finishing touches in this department. 
It is taken from this room and applied to the person ; or more likely 
packed in a box and sent by express to its distant wearer. 
m The fitting rooms are on a floor by themselves. 

The office and showroom occupy the ground floor of the premises. 




No. 1193.— Banding. 



A large number of samples are on display, covering all the peculiar 
classes of limbs for every character of amputation. 

A part of the office is appropriated to escritorial work. Stenogra- 
phers receive responses to letters by dictation, which average over a 
hundred a day. They are transcribed by typewriting machines in 
duplicate. Records of every inquiry are kept in order, and a perfect 
memorandum of every transaction made. The details of this office are 
multifarious, keeping nearly a dozen persons constantly busy. The 
office is equipped with every convenience to make a visitor feel at 
home, and to help him while away the time that would otherwise be 
tedious and weighty. When parties visit the establishment they are 
received cordially and made welcome to all its conveniences. 

If they remain over night, they are escorted to hotels, boarding or 
lodging houses in the neighborhood. 

A large fire-proof safe preserves all records, and at the same 



A. A. MAEKS, ARTIFICIAL LIMBS, NEW YOEK CITY. 



359 



time affords the visitor a place to deposit his valuables and money 
while he remains in the city. 

Cut No. 1198 represents a transverse sectional view of our establish- 
ment which has a frontage of twenty-five feet, and occupies a lot one 
hundred feet deep. It consists of five floors, in addition to a basement 
and a sub-cellar. The sub-cellar is used for the storage of plaster molds, 




models, boxes, etc. The basement is used for packing and shipping 
artificial limbs and other goods, receiving stock and raw material. 

The store is on a level with the sidewalk; it is fitted up as a show- 
room, reception room, and office; it also contains private rooms for 
measuring and fitting. The arrangement is such as to save patrons the 
necessity of climbing stairs. The second floor contains the finishing 
room and additional fitting and reception rooms ; also a crutch depart- 



360 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



ment. The third floor is entirely devoted to woodworking. The fourth 
floor contains the machinery, knitting, and stock departments. The 
fifth floor is used for the storage of timber, etc. 




The following article, taken from the Scientific American, August 3, 
1895, describes the process of artificial limb making in a way that is 
worthy of the reader's attention : 



THE MANUFACTURE OF ARTIFICIAL LIMBS. 

It would be hard to find a more beneficent example of the progress 
of mechanical science than that afforded by the peculiar industry we 
describe and illustrate in this issue. The artificial limb manufacturer 
ranks, in a sense, with the reparative surgeon in the good he does to 
humanity. Especially at the present day his operations are of impor- 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



361 



• tance. The cases of amputation are getting more and more frequent. 
Trolley cars, steam railroads, agricultural machinery, and factories are 
all responsible for many accidents, and naturally they are increasing 
in number. In early days the old peg leg of the Peter Stuy vesant type 
represented the best substitute for the natural member. The hook of 
Captain Cuttle recalls the substitute for the other members in vogue 
some years ago. 




Manufacturers of these primitive affairs attempted to improve their 
products, and produced arms and legs with joints. The complicated 
natural leg was the model, and efforts were directed to reproduce its 
motions. Much ingenuity was expended in this direction, and in due 
course of time, through simplification of its parts, the structure, as lias 
been aptly said, " passed through all the possible stages from the leg 



362 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



automaton to the leg practical." The object of this article is to show- 
how the artificial leg of the day is made, and our sketches have been 
made at the establishment of A. A. Marks, of New York City. A 
curious collection of envelopes is framed and displayed in the office of 
the firm — envelopes addressed to them and which inclosed correspond- 
ence from every country, and which would in many cases be treasures 




to the philatelist. They are exhibited to show how the entire world 
draws upon their factory for artificial limbs. 

The leg with restricted back and forward ankle motion was con- 
structed by Mr. A. A. Marks during the interim 1853-1863. The joint 
included a spring adjustable for tension and provided compensation for 
wear. The experience of ten years showed that the ingenious and 
much praised ankle joint was too weak for hard service, and repairs 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



363 



were very frequently required. A patient applied to Mr. Marks for a 
new foot without ankle joint. The idea, opposed to preconceived 
notions, was carried out with some difficulty, and the problem was 
practically solved. Now, except in very special cases, the ankle joint 
is definitely abandoned, and the India rubber foot, the result of a vast 
number of experiments, patented and controlled by this firm, is 
employed. 

The first step in the process of leg making is the cutting of the timber. 
Two kinds of wood are used — the willow and the bass. These are 




-The capacity represents an output larger than the aggregate of any other ten Artificial 
Limb Factories in the world."— Scientific American. 

No. 1198. 
felled with saws, are cut into short lengths, and an auger is driven 
through each log. The wood is kiln dried in live steam at a pressure 
of eighty pounds to the square inch. The endeavor in boring out the 
axis of the log is to provide for internal contraction, thus preventing 
checking. Several years' seasoning are given. 

The seasoned wood, which has been roughed out with a buzz saw, is 
received in the factory and is ready for the workman . Fig. 6, g, Cut No. 
1203 shows a log prepared for the shaping process. The workman has 
to give the interior a shape representing the contour of the stump 
on which the shape is based. With peculiar carving tools the 
interior is rapidly excavated until the approximate shape is reached. 
As guide or template for the interior, two pasteboard profiles (Fig. 
6, d) of the stump are used, together with metal rings (Fig. 6, «), 



364 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



giving the girth of the stump at different places. The exterior is 
brought to shape by the drawing knife for the first steps, followed by 
the gouge (Fig. 6, b), spoke shave, rasp, and sandpaper successively. 
The operation of carviQg the exterior of the leg is shown in one of the 
cuts, Cut No. 1201. The interior is brought to its final shape by re- 
volving sand wheels, which smooth it out to precise contour. The 




No. 1199. — Shaping Machine Turning Leg Section. 



wheels, made of glue and sand on a core, are carried on the end of 
spindles rotated at high speed by power, and these are moved about 
against the interior of the leg until it is finished. Coarse and fine 
wheels are used. The operation is shown in Cut No. 1200, in which 
also is seen a workman facing off the end of the leg to receive the foot. 

The foot is made upon a wooden core which extends down below the 
instep. The lower portion of the foot and the extension to the toes are 
made of sponge rubber, fortified with several layers of canvas embedded 
in the mass. The foot is rigidly secured to the ankle end of the lower 
limb by a sort of mortising. Sometimes the section of a log is turned 
out on a shaping machine from a template or duplicate, and one of the 
cuts, No. 1199, shows this machine in operation. 

The leg is covered with rawhide tightly stretched over the outside of 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 365 

the wood ; the foot is covered with calfskin cemented on the upper 
surface and lapping over the sole. A sole is cemented on and is 




No. 1200. — Finishing Interior of Leg and Facing off Ankle End. 
No. 1201.— Carving Leg Sections by Hand. 

sewed all around the edge to the upper covering. The foot and leg are 
now enameled and dried in an oven. This leaves them waterproof 



366 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



for all ordinary purposes. These operations, one of which is shown in 
Cut No. 1203, are termed finishing. 

But for special cases, where water is to be feared, a log is selected 
whose natural grain follows the cuiwe of a leg and foot. From such a 
piece the entire lower leg and wooden core of a foot is made all in one 
piece, and the rubber portion of the foot is attached directly thereto. 
This makes an absolutely waterproof leg, which is adapted to those 
whose occupations expose them to wetting. 

The knee joints are made in several ways, whose details cannot well 




No. 1202. — Setting up Legs. 



be gone into here. The operation of setting up the leg and connecting 
the knee joints is shown in Cut No. 1202. These joints have been, in 
some cases, constructed on principles adapted to the ideas of the 
wearers, where such seemed good practice. The elasticity of the foot, 
due to the depth of sponge rubber at the heel and to the long rubber 
toe, takes the place of the ankle joint. 

Artificial arms are made in the same way. India-rubber hands are 
used instead of the old wooden ones. Sometimes a hand with malle- 
able wire finger cores is employed. Holes are bored in the wooden 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



367 



core of the hand into which the doubled ends of bundles of wire 
(Fig. 6, ♦&) are inserted and pinned ; h shows the hand thus far 
advanced. Tape wrapping is then applied until the fingers reach the 
proper size, shown in i, when all is ready for the coating of India 
rubber. This hand can have its fingers bent so that it can hold a pen 
or other light instrument. In Fig. 6, /, are shown a knife and brush 
adapted to be inserted in a socket in the hand. The small projecting 
handle is used to insert them with. 




No. 1203.— Finishing Legs and Arms.— Details and Parts 
of Artificial Limb Making. 



The beneficent results of this work have been mentioned. In the 
Marks factory is a workman with two wooden legs. He does a full 
day's work standing at his bench, and then will often play billiards 
all the evening. It is impossible to believe that he depends altogether 
on artificial limbs. Tight rope walking, hurdle jumping, and other 
apparently impossible feats are performed by wearers of the Marks 
limbs. As a mechanical process the operation of wooden leg making 



368 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITT. 



is most interesting, and the limits of this article preclude a full 
description. 

The noise of machinery, the humming of wheels, the buzzing of 
saws, and the many men stationed at their benches show that the 




No. 1204. — Mortising. 



industry is of far greater magnitude than anyone would suppose. 
There are over forty employees in this establishment, and the capacity 
represents an output larger than the aggregate of any other ten 
artificial limb factories in the world. 



AWARDS. 

The first industrial exhibition at which Mr. Marks exhibited his 
artificial limbs was at the Crystal Palace in New York City in 1858. 
As that exhibition was destroyed by fire during its progress no awards 
were given. 



1859. 
The American Institute in New York City held an exhibition in the 
fall of 1859. The silver medal was awarded to A. A. Marks for his 
superior artificial limbs. This was prior to the invention of the rubber 
foot, and consequently had no reference to it. 



1865. 
AMERICAN INSTITUTE, NEW YORK, GOLD MEDAL. 
Judges' Report: 

After a careful and extended examination and practical testing of 
the various kinds of limbs on exhibition, we award the First Premium 
Gold Medal to artificial limbs with rubber hands and feet. 

J. M. Carnochan, M. D., J. C. V. Smith, M. D., James Knight, 
M. D. 



1867. 
AMERICAN INSTITUTE, NEW YORK, FIRST PREMIUM. 
Judges' Report: 

Marks' Patent Artificial Limbs have frequently been before the 
Institute and continue to sustain their former reputation. The First 
Premium is consequently awarded. 
A. K. Gardner, M. D., J. C. V. Smith, M. D., J. J. Craven, M. D. 



1869. 
AMERICAN INSTITUTE, NEW YORK, FIRST PREMIUM. 

Judges' Report: 

Artificial Limbs, A. A. Mark's Best. This limb is constructed with 
an india-rubber foot, which, from its elasticity, does away with the 
necessity of motion at the ankle joint, and also obviates entirely that 
heavy, thumping sound when the foot strikes the ground in walking, 
an objection which exists in all other "artificial legs which the com- 
mittee have any knowledge of. 

The control which the wearer has over it and its movements, so 
closely resembling those of the natural limb, as well as the small cost 
of keeping it in repair (almost nothing), entitle it to the highest 
commendation. 

Lewis A. Sayre, M. D., Jas. R. McGregor, M. D., Judges. 



370 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

1870. 
AMERICAN INSTITUTE, NEW YORK, FIRST PREMIUM. 

Judges' Report i 
Marks' Artificial Limbs. 

Best. 

The especial point of excellence appears to us to be the india-rubber 
foot, by the use of which all complications in the construction of an 
ankle joint are avoided. 

Frank H. Hamilton, M. D., Harvey S. Gay, M. D., Wm. H. 
Van Buren, M. D., Judges. 



1871. 
AMERICAN INSTITUTE, NEW YORK, FIRST PREMIUM. 
Judges' Report : 

.The artificial limbs with india-rubber feet are especially recom- 
mended for their simplicity, durability, and easy movement. Signed 
by the Judges. 



1872. 
AMERICAN INSTITUTE, NEW YORK, FIRST PREMIUM. 

The artificial limbs manufactured by Mr. Marks continue to merit 
approval, and are entitled to all the confidence the public have to this 
time reposed in them. 

John Osborn, M. D., Harvey S. Gay, M. D., Frank H. Hamilton, 
M. D., Judges. 



1873. 
AMERICAN INSTITUTE, NEW YORK, FIRST PREMIUM. 

Report of Judges : 

After full and impartial examination of the articles above described, 
the undersigned Judges make report that they find the artificial limbs 
on exhibition by A. A. Marks worthy of the confidence heretofore 
reposed in them. We cheerfully endorse all that has been said of 
them by former examinations, their simple construction, easy move- 
ments, durability, etc. 

John Osborn, M. D., D. F. Fetter, M. D., C. D. Varley, M. D. 



1874. 
AMERICAN INSTITUTE, NEW YORK, FIRST PREMIUM. 

Report of Judges : 

We consider the artificial limbs of A. A. Marks of great value. 



A. A. MAEKS, ARTIFICIAL LIMBS, NEW YORK CITY. 371 

A great improvement— better than any known to us ; and of their 
grade entitled to the highest award. 

A silver medal awarded in 1873, as the best; a diploma of main- 
tained superiority is now awarded. 

V. P. Gibney, M. D., H. B. Sands, M. D., E. G. Janeway, M. D., 
Judges. 



1875. 
AMERICAN INSTITUTE, NEW YORK CITY, FIRST PREMIUM. 

Judges' Report : 

After a full and impartial examination of the articles above 
described, the undersigned Judges make report that the artificial limbs 
presented by Mr. Marks are the same as those offered by him at former 
exhibitions. We regard them as superior to all others in practical 
efficiency and simplicity, and would respectfully recommend the 
award of a diploma of maintained superiority. 

Francis A. Thomas, M. D., Charles W. Packard, M. D., J. R. 
McGregor, M. D., Judges. 



1876. 

CENTENNIAL EXHIBITION, PHILADELPHIA, PA., FIRST 

PREMIUM. 

Report of Judges and award of the Commission : 

International Exhibition, Philadelphia, 1876. 

The United States Centennial Commission has examined the report 
of the Judges, and accepted the following reasons, and decreed award 
in conformity therewith. 

REPORT OF AWARDS. 

Products : Artificial Limbs, with Rubber Hands and Feet, invented 
by A. A. Marks, New York. 

The undersigned, having examined the product herein described, 
respectfully recommends the same to the United States Centennial 
Commission for award, for the following reasons, viz.: UTILITY, 
WORKMANSHIP, and ADAPTATION TO PURPOSE INTENDED. 

Henry H. Smith, Professor of Surgery. 

Approval of Group Judges. H. K. Oliver, Edward Conley, B. F. 
Britton, Spencer F. Baird, Chas. Staples, Jr., M. Wilkins, 
J. Fritz, Jas. L. Claghorn, Colman Sellers. 
A true copy of the record. 

Francis A. Walker, Chief of the Bureau of Awards. 
Given by authority of the United States Centennial Commission. 

A. T. GOSHORN, Director-General. 
J. L. Campbell, Secretary. J. R. Hawley, President. 



372 A. A. HARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

1876. 
AMERICAN INSTITUTE, NEW YORK, SPECIAL GOLD 

MEDAL. 
Judges' Report: 

We consider the limbs made by A. A. Marks remarkable for simpli- 
city of construction, durability, efficiency, and comfort to the wearer. 
We think them entitled to the highest commendations, and believe 
that their merits call for an award of the Centennial Medal. 

Francis A. Thomas, M. D., Charles W. Packard, M. D., J. R. 
McGregor, M. D., Judges. 



1877. 
AMERICAN INSTITUTE, NEW YORK, MEDAL FOR 
SUPERIORITY. 
Judges' Report: 

A. A. Marks. — After a full and impartial examination of the articles 
above described, the undersigned Judges make report that we consider 
this exhibit of great value and entitled to recognition. 

Charles W. Packard, M. D., Francis A. Thomas, M. D., August 
Viele, M. D., Judges. 



1878. 

AMERICAN INSTITUTE, NEW YORK, MAINTAINED 
SUPERIORITY. 

Having received the Medal of Superiority in 1877, this Diploma for 
Maintained Superiority is awarded to him at the Exhibition of 1878. 

Nathan C. Ely. President. 
G. K. McLeoser, Recording Secretary. 



1881. 

INTERNATIONAL COTTON EXPOSITION, ATLANTA, GA., 
FIRST PREMIUM, GOLD MEDAL. 

Judges' Report. 

The undersigned having examined the artificial limbs of A. A. Marks 
of New York, respectfully recommend the same to the Executive 
Committee of the International Cotton Exposition for the following 
reasons, viz. : 

First. Simplicity in the mechanism of the knee-joint and for its 
excellent movement. 

Second. Durability. 

Third. Rubber Foot, possessing many excellent qualities and compen- 
sating for the absence of motion in the ankle joint. 

We recommend that a gold medal be awarded. 

Approval of Group Judges, Chas. L. Wilson, M. D., Amos Fox. 

Approved, H. I. Kdiball, Director-General. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 373 

1885. 

THE WORLD'S INDUSTRIAL AND COTTON CENTENNIAL 
EXHIBITION, NEW ORLEANS, LA., GOLD MEDAL. 

Artificial Limbs. 

jurors in the above entitled class having carefully examined the 

exhibit made by A. A. Marks, New York, and all competing exhibits, 

concur in recommending the award of the First Class Medal for 

Artificial Limbs. 

S. D. Carroll, 

For Department of Awards. 



1889. 
THE JOHN SCOTT LEGACY PREMIUM AND MEDAL. 

John Scott, chemist, late of Edinburgh, by his will made in the year 
1816, bequeathed a sum of money to the Corporation of the City of 
Philadelphia, directing that the interest and dividends received there- 
from shall be laid out in premiums, to be distributed among ingenious 
men and women who make useful inventions, and that therewith shall 
be given a medal with this inscription : 

"To The Most Deserving." 

REPORT OF THE COMMITTEE OlJ SCIENCE AND THE ARTS OP THE 
FRANKLIN INSTITUTE, ON MARKS' ARTIFICIAL LIMBS. 

This subject was submitted to the Committee on Science and the Arts 
for examination, and upon the reading of the report and exhibiting the 
specimens and illustrations, appeared to be of sufficient interest to 
warrant the attention of the Institute at this meeting, and a concise 
abstract of the report was accordingly prepared. This abstract follows 
and describes the inventions in their several stages of progress. 

The first improvement consisted in the substitution of an elastic 
artificial foot, made of india-rubber, without any joints whatever, for 
the artificial foot, previously made of wood, with joints to permit 
motion of the ankle and toes, and also an artificial hand made of india- 
rubber, simulating the missing member. 

The rubber foot consists of a wooden block rigidly secured or formed 
with the leg and extending downwardly to within about two-fifths of 
the distance from the ankle to the sole, and forward to nearly the first 
articulation of the metatarsus and toes ; this block was covered with 
india-rubber, and all the rest of the foot, £rom heel to toes, was formed 
of elastic vulcanized rubber. 

The action of such an artificial foot was that of an elastic segment of 

a wheel. The shock of placing the weight upon the heel at each step 

was avoided by the elastic cushion of rubber forming the heel, and as 

the weight was progressively transmitted to the forward part of the 

/ foot, by the combined effect of muscular exertion in the remaining part 



374 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

of the natural limb to which it was applied, and the momentum pre- 
viously acquired, an easy flexure of the toes took place, which, react- 
ing elastically as the weight was transferred to the other limb, assisted 
in the flexure of the knee-joint, giving an easy and naturally appear- 
ing movement. Such artificial feet were, upon trial by those who 
were maimed and had used other artificial substitutes, found to" be 
easier to use, lighter, and more comfortable. They were rapidly intro- 
duced into use, and have proved, from their greater simplicity, more 
durable and far less destructive to clothing. 

The next improvement is an improved and simplified construction 
of the knee joint of artificial limbs, made with a view to strength, 
facility of accurate manufacture, and easy application. This joint con- 
sists of a flanged plate, secured by screws to the under surface of the 
thigh-socket, and has formed, integrally with it, of steel, by drop forg- 
ing, a cylindrical pillar, terminating in two lateral journals having the 
same axis, resembling an inverted capital letter T. 

These journals perform the function of the condyles of the femur in 
the natural limb, and are fitted accurately in bearings formed with 
oblique caps, secured by screws in the rear of the knee portion of 
the leg. 

On the rear of the pillar, in about the same horizontal plane as the 
axis of the journal when the limb is extended, is formed a short lever, 
having a spherical end, against which a cup, formed upon the upper 
end of a sliding plunger, is pressed upwardly by a spring in a guiding 
cylindrical case, having a conical lower end resting in a correspond- 
ingly shaped cup in the interior of the calf portion of the leg. When 
the limb is extended, the spring operates with full effect, in holding 
the limb extended ; as it is flexed, the lever gradually assumes a greater 
angle to the line of reaction of the spring and cup, so that when it is 
flexed with the thigh at right angles with the leg the spring has no 
motion or effect, and if flexed still further the spring then operates to 
assist in further flexure. The pillar and journals are made hollow, so 
as to reduce their weight. 

It is obvious to every mechanic, that from the shape of these parts 
they must possess great strength, and that they can easily be fitted into 
their working positions. 

Another useful feature of this form of joint is that the upper part of 
the pillar forms an effective stop, to arrest the forward motion of the 
thigh upon the leg during extension, by coming in contact with a 
cushioned cavity in the rear of the knee ; this point of support, being 
at a considerable distance from the axis of the knee-joint, avoids any 
severe strain and shock from the sudden extension of the limb, which 
in other constructions, having the stops made in plates at the sides of 
the joint, are necessarily close to the axis of motion, and consequently 
are subjected to a greatly increased strain. 

This concussion of the stop is found to be a frequent cause of break- 
ing both of the stops and joints, of other forms of limbs, and has had a 
great deal of ingenuity expended upon it to avoid it, by providing 
check straps or cords, reaching from the thigh to the leg, and designed 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 375 

to stretch tight before contact of the stops occurs. These cords required 
greater care to keep adjusted to the proper tension than could readily 
be given to them. The simple contrivance, here shown, obviates the 
entire difficulty. 

The axis of the knee-joint is placed near the back of the limb, so that 
the weight of the wearer ensures a firm support on the limb when 
extended, and at the same time slight exertion suffices to move the limb 
in stepping forward. 

The shell, or parts which in form imitate the natural limb, are made 
of light willow or bass wood, as thin as is consistent with strength in 
the lower part, and in the upper part excavated to fit the remaining 
portion of the natural limb ; these are covered tightly with parchment 
and painted and varnished to resemble the complexion of the natural 
skin. 

The continued use of the limbs thus constructed demonstrated that 
the front portion of the foot was too easily flexible, or rather that 
greater elastic force was desirable, and this requirement was met by the 
inventor by a device in which a textile fabric was introduced between 
the lamina of india-rubber forming the ball and toe portion of the foot, 
as here shown in the drawing. 

The desire to adapt the india-rubber hands to changes of flexure, for 
purposes of better and more natural appearance and to grasp light 
objects, led Mr. Marks to improve them by making a light wooden core 
in the palm or metacarpal portion of the. hand and inserting ductile or 
flexible metallic wires in such core, which extended centrally through 
the fingers. By bending the fingers they retain the form in which 
they are set. The test of several years' use of these last-named 
improvements has proved their desirability. 

The latest improvements in artificial limbs consists in forming the 
leg and foot part of a single piece of wood, having the grain curved 
naturally in its growth, such pieces being procured from the parts of 
the trunk contiguous to the roots and branches of trees; limbs made in 
this way are stronger with the same amount of wood remaining in 
them than when made of parts and glued together, and are made 
waterproof, which is a valuable feature when the occupation of the 
wearer exposes it to constant dampness, or to water itself, as in fishing, 
mining, dredging, etc. 

By making limbs in this manner from natural curves in the growth 
of the wood, it has become practicable to make light and substantial 
artificial feet, adapted to partial amputation of the foot. Such appli- 
ances are shown herewith, and have been used with unprecedented 
satisfaction where articulated feet were clearly impossibilities. 

The advantages derived from the lightness of such artificial substitutes 
will readily be apparent when the resistance to motion from inertia is 
considered. The ankle and foot and lower part of the limb, being light 
and hollow, move easily and promptly with but little exertion from 
the remaining part of the natural limb, and the comfort and ease of the 
wearer are thereby greatly promoted. 

With the specimens of limbs are submitted well-perfected adjuncts 



3*76 A. A. MARKS. ARTIFICIAL LIMBS, NEW YORK CITY. 

in tlie way of suspender straps and girdles, and great ingenuity and 
skill have been displayed by these inventors in adapting limbs to 
specific cases which, while useful and light and highly commendable, 
cannot be particularized in this report. 

The Franklin Institute has not made any examination in this 
department of the arts since January 11, 1849, when, as appears on 
page 61, vol. xlix., of the Journal, they reported upon the merits of 
the Palmer artificial limbs. Since that time about sixty or more 
patents have been granted for alleged improvements in artificial limbs, 
nearly all of which, except these which are the subject of this report, 
added complications or additional parts to the limbs. In none of those 
inventions does there appear such desirable simplicity of construction 
as. in those under consideration. The makers are enabled to make 
most durable and substantial workmanship of all parts, and have 
demonstrated all of these points by making many thousand which are 
in constant and satisfactory use. 

The extreme simplicity of construction has proved the means of 
bringing their cost within the reach of many persons requiring such 
appliances, who could not otherwise afford to use and maintain them, 
and there are now many persons using them and actively competing 
with others in many lines of industry, among them machinists, black- 
smiths, farmers, fishermen, carpenters, molders, instrument makers, 
railway conductors, engineers, and, in fact, representatives of nearly 
every handicraft. 

Mr. Thomas Kehr, a skilled workman in all branches of their manu- 
facture, who works daily at the bench, standing upon two of them, 
demonstrated publicly at the Institute meeting the facility of use and 
value in walking better than anything that can be said upon the 
subject. (One of Mr. Kehr's legs was amputated in the middle of the 
femur and the other an inch and one-half below the patella.) 

[The report of which the foregoing is an extract, and which embraced 
the recommendation of the award of the John Scott Legacy Medal and 
Premium, was signed by S. Lloyd Wiegand (Chm.), L. L. Cheney, 
and N. H. Edgerton, and approved and adopted by the Committee on 
Science and the Arts, at its stated meeting, held-Wednesday, February 
6, 1889.] 

The above report was presented to the committee appointed by the 
City of Philadelphia, under the auspices of the Franklin Institute, and 
it was unanimously decided that the John Scott Legacy Medal and 
Premium should be awarded to A. A. Marks for the merits contained 
in his artificial limbs. The house of A. A. Marks thereby being 
designated as : 

The Most Deserving. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 377 

1891. 
AUGUSTA EXPOSITION, AUGUSTA, GA. 

Seven Gold Medals and Awards for distinct and separate features of 
excellence. 

First. For Improved Artificial Legs with Rubber Feet. 

Second. For Improved Artificial Arms with Rubber Hands. 

Third. For Superior Methods of Suspenders for Artificial Legs and 
Arms. 

Fourth. For Superior Crutches and other Auxiliaries for Cripples. 

Fifth. For a Combined Knife and Fork for the use of one-armed 
men. 

Sixth. For Improved Waterproof Artificial Legs, carved from 
natural crook timber. 

Seventh. For Improved Artificial Legs and Arms with Aluminum 
Sockets. 

The reports of the Judges on each of the above awards were signed 
by the following : 

Thos. R. Wright, M. D., ) Surgeons S. Lesser, ) 

E. C. Goodrich, M. D., V . pjL ro . p Jno. W. Clark, > Judges. 

W. H. Doughty, Jr., M. D., ) g ' R. M. Sims, J 

E. J. O'Connor, M. D., 

Committee of Awards. 



1893. 

The Elliott Cressons Gold Medal, awarded to A. A. Marks for 
aluminum socket artificial legs and arms, as stated in the following 
report : 

THE COMMITTEE ON SCIENCE AND THE ARTS OF THE 
FRANKLIN INSTITUTE. 

Subject.— Marks' Improvements on Artificial Limbs. 

At the stated meeting of the committee on Science and the Arts of 
the Franklin Institute, held February 1, 1893, the following report 
was adopted and ordered to be issued over the signature of the Chair- 
man and the certification of the Secretary, viz. : 

This invention consists of an improved method of making artificial 
limbs, adapted to amputations in the ankle, or below, in the tarsus or 
metatarsus, in which the former modes of construction, with articul- 
ated ankle-joints of wood as the material, were impracticable and 
unsatisfactory in result; although sometimes made when wood was 
employed as a material, these were always clumsy, and when the 
articulated ankle was attempted, it proved inoperative. The new 
method of construction involves the use of aluminum as the material 
to form the shell socket or sustaining frame, as it might be called, the 
aluminum shell supporting the body, and forming the attachment for 
the elastic rubber foot, which acts as a rolling elastic segment simulat- 



378 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

ing the functions of the natural foot in walking, and acting as an 
elastic cushion in relieving the wearer from the jar or shock of resting 
the weight upon the limb. At the same*time they resemble the form 
of the natural foot more closely than was possible with previous 
constructions. 

The invention is described and set forth in United" States Letters 
Patent No. 470,431, dated March 8, 1892. 

The specimen submitted to the committee shows the invention to be 
extremely light, and so compact as to make no noticeable enlargement 
of the artificial foot beyond the size of the natural foot, thus com- 
pletely restoring the appearances. 

Your committee has examined the limbs in the course of manufac- 
ture, and as completed and as in use by wearers. When clothed, they 
give no indication in walking that they are not natural feet. 

The mode of making the aluminum shells consists in first producing 
a plaster cast of the mutilated member to which it is to be applied. 
Upon this plaster cast is fitted a pattern carved in the usual manner, 
and prepared for the founder. The aluminum shell is then cast from 
this pattern. 

The limb embraces four elements: First of these is the metallic shell 
or frame ; its functions are to receive the weight of the wearer at its 
upper part, and transmit it to the foot. 

The second is the removable elastic foot : this is so proportioned in 
thickness in its several parts as to hold securely on the lower portion 
of the frame and to act as an elastic cushion in receiving the weight 
upon the heel and transfer it as the step progresses to the ball of the 
foot and toes, which, under the pressure, flex, and again extend as 
they are relieved of weight, thus closely imitating the action of the 
natural foot. 

The third element in the structure is the leather jacket, which con- 
fines the limb in the metallic shell or frame so that the weight is 
received on the upper portion. 

This jacket of leather is attached to the shell by a few rivets, which 
can easily be removed and a new leather expeditiously substituted at 
small cost by any saddler or other leather worker without entailing 
the delay of sending the limb to the original manufacturers. 

The fourth and last element is the pad in the base of the cavity of 
the aluminum shell or frame; the pad is made of cork in the specimen 
submitted, and covered with felt on the upper surface ; a pad of wool 
or any other similar substance could be substituted with like effect; the 
cork has the advantage of being light, and is easily removed, cleaned, 
and replaced. 

The combinations of these parts forms a limb which, with inexpen- 
sive repairs, easily procurable with little delay, has almost unlimited 
durability and affords a much needed relief to many who heretofore 
were dependent upon crutches for aid in locomotion. 

The invention, regarded from a humanitarian standpoint, is of great 
importance. Although it was less than two years from the making of 
the first specimens at the time this invention was shown at the Insti- 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 379 

tute and referred by resolution to the committee for examination, 
yet 134 at that time had been brought into practical use, as appears 
from an inspection of the books and correspondence of the manufac- 
turers, and all of them found to be satisfactory in performance. 

Such a practical indorsement from the users, and those only fully 
qualified to test the merit of this class of inventions, is indicative of the 
great merit and suggestive of the extended field of usefulness of the 
invention. 

The following, from the impression of the New York Medical Jour- 
nal of April 16, 1892, sets forth better the importance of the invention 
from a humanitarian standpoint, as viewed by surgeons, than your 
committee feel competent to express in any other terms : 

"There are amputations of the lower limbs that surgeons deem desirable to do 
without sacrificing more of the member than the parts involved. We refer to ampu- 
tations technically termed tibio-tarsal, tarso-metatarsal, and medio-tarsal. These 
amputations have always been in disfavor with artificial limb makers, who have 
almost unanimously decried them, and in too many instances have persuaded the 
surgeons to sacrifice much of a healthy leg merely to obtain a stump that would 
better accommodate the artificial limbs that they were able to produce. 

" The new artificial leg, constructed of aluminum combined with the rubber foot, 
is adapted to these amputations. The socket of aluminum encases the stump, and on 
account of the strength of the metal the socket does not increase the diameters of the 
ankle to an objectionable degree in order to obtain the requisite strength. The 
metal is cast into the proper shape to give ease and comfort to the wearer ; the 
aluminum socket is terminated by a rubber foot, which not only simulates the nat- 
ural foot, but provides a soft, springy medium to walk upon, and a resident phalan- 
geal ball to rise upon while walking, running, or ascending stairs. 

"It is obvious that by this iuvention the amputation can be conditioned upon 
the injury and the artificial limb conditional upon the amputation. In this alone the 
invention of the aluminum and rubber leg will prove not only a boon to the one who 
has suffered the amputation, but the solution of a problem that has many times per- 
plexed the operating surgeon, as it eliminates all the objections heretofore pressed 
against amputations in the region of the tarsus. The sui'geon may thus rejoice 
in being able to observe the old and consistent law of amputating with the least 
sacrifice." 

It is, therefore, clearly apparent that the invention is one affording 
much-needed relief to persons heretofore greatly embarrassed, and 
further that the surgeons may save much more of the patient's body 
from mutilation than heretofore, and yet render comfortable and sat- 
isfactory artificial limbs practicable. 

In view of these points of excellence and well-attested evidence 
thereof the committee awards the Elliott Cresson Medal to Mr. Marks, 
of New York, for his improvements in artificial limbs. 
Adopted February 1, 1893. 

H. R. Heyl, 
Chairman Committee on Science and Arts. 
Certified as a correct copy. 

W. H. Wahl, Secretary. 



380 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



HIGHEST AWARD, WORLD'S COLUMBIAN EXPOSI- 
TION, CHICAGO, ILL., 1893. 

The display of artificial limbs in this memorable Exposition must 
be regarded as the most extensive and varied ever brought together 
under the same roof. Nine different manufacturers were here collected , 
in active competition with each other. 



im Lib^alarjs see. b. 103. 

^9RLDXea\JMB!ANEXP95|Tl^' 

CmeAGo, 1893. 




THEm£HESTAWAR D 
f TOR i\RJIFI<2IAL LIMBS. 



The space allotted to A. A. Marks covered an area of one hundred 
and eighty square feet. On this space were placed four large show 
cases, roofed by a gilded dome, and surmounted by a colossal golden 
leg. 

The cases contained artificial legs and arms for amputations in the 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 381 

hips, thighs, knees, legs, ankles, feet, shoulders, arms, elbows, fore- 
arms, wrists, hands, and fingers, also apparatus for extending short- 
ened legs, for supporting weakened [knees and ankles, and for the 
correction of deformities. They comprised over fifty specimens. 

The exhibit was attended by a medical student, who wore an artificial 
leg for amputation above the knee ; and two assistants, who wore pairs 
of artificial legs with rubber feet. 

Literature printed in English, Spanish, French, and German was 
liberally distributed. 

The Judges appointed to investigate artificial limbs were more than 
usually searching and scrupulous. The following points on which we 
claim excellence were considered by the Judges : 

ARTIFICIAL LEGS. 

First. — Rubber Foot, (a) Its close approximation to the motions 
and actions of the natural foot, when standing, walking, running, 
ascending or descending steps, elevations in grounds, etc. 

(b) Its durability and lightness; the yielding and elastic qualities of 
rubber supply requisite motion without necessitating mechanism ; the 
absence of this mechanism admits of strength and lightness. 

(c) Phalangeal assistance. The methods of construction and connec- 
tion with the body of the leg in each case are such as to provide assist- 
ance in walking from the anterior portion of the foot, at the same time 
maintaining the height of the wearer when walking, same as is 
obtained from the natural foot; the feature of phalangeal assistance 
avoids limping, and removes the fear of toppling forward when 
standing. 

(d) The elasticity of rubber affords a yielding medium to alight upon, 
thus avoiding jars and concussions to the stumps. 

Second.— Knee Joints, (a) The construction of knee joints is such 
as to render them capable of adjustment, thus obviating the noise that 
follows attrition. 

(6) The disposition of the knee spring, which assists extension of the 
lower leg, is such as to become neutralized when the leg is flexed to a 
given angle; this avoids "kicking out" of the lower leg when the 
wearer is sitting and unguarded. 

(c) Safety lock. This attachment is combined with the knee mech- 
anism, and provides against treacherous flexing of the knee, thus 
avoiding dangerous falls . 

Third.' The production of waterproof legs from natural crook timber 
with rubber feet attached. This method provides artificial legs for 
miners, fishermen, woodsmen, to walk, stand, and labor in watery or 
damp places without impairment to their legs. 

Fourth. Aluminum sockets, especially designed for stumps that 
extend to the ankle and in the body of foot, known by the profession 
as tibio-tarsal, medio-tarsal, and tarso-metatarsal amputations. 

The advantages obtained by the utilization of this metal are as 
follows : 



382 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

(a) The production of a socket that can be close] y fitted to the stump, 
without touching or allowing painful contact with any of the tender 
spots on the stump, at the same time possessing sufficient strength to 
properly support the wearer, no matter what position he may be 
placed in. x 

(b) The construction of a socket that will possess the requisite 
strength, without conspicuously enlarging the extremity of a stump 
that has a bulbous end. 

Fifth. Roller Suspenders. The object of this method of suspending 
an artificial leg to the wearer is to avoid the moving and rubbing of 
the shoulder straps on the shoulders. The pulleys placed on the sides 
of the leg admit of the movements of the suspender taking place on the 
rollers and not on the shoulders. 

ARTIFICIAL ARMS. 

First. — The Rubber Hand, (a) Being composed of rubber, is 
pleasant and natural to the touch and durable in construction. 

(b) The fingers being ductile, can be placed into accommodating 
positions. 

(c) The palm of the hand, being provided with a locking socket, is 
capable of holding implements of utility with firmness. 

Second. The ability to detach the hand at the wrist for laboring 
purposes. 

Third. Rotation of hand at wrist, to provide for pronation and 
supination. 

Fourth. The elbow joint, with lock for holding the arm in a flexed 
position. 

Fifth. Fingers and parts of hands made of rubber, to replace 
fingers and parts of hands that have been amputated. 

Sixth. Rotation of upper arm socket. 

The report of the Judges was an indorsement of the above claims. 

awards. 

For size and importance of the collection; durability, lightness, and 
strength of material ; improved methods of construction, attachments, 
and superior workmanship. 

Signed by, 

Jennie McCowen, M. D., 
R. Buerz, 
J. H. Gore. 

In conformity with the Judges' report, the highest award (medal and 
diploma) was declared in favor of A. A. Marks, 701 Broadway, New 
York City. 

Two additional diplomas were awarded by the Board of Lady 
Managers, one for DESIGN, and the other for INVENTION. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 383 



1895. 

COTTON STATES AND INTERNATIONAL EXPOSITION, AT- 
LANTA, GA., HIGHEST* AW ARD-A DIPLOMA OF HONOR, 
AND A GOLD MEDAL. 

This certifies that the appropriate jury has awarded to A. A. Marks 
of New York City the Gold Medal "For the most complete exhibition 
of ingenious mechanics for the relief of physical defects and 
deformities, namely: Artificial Legs, Rubber Feet, Artificial Knee 
Joints, Self-Adjusting- Suspenders, Artificial Arms, Rubber Hands, 
Duplex Elbow Joints, and Aluminum Socket Legs ; also for Imitating 
the Movements of Knee, Elbow, Wrist, and Finger Joints." 

Daniel C. Gilman, Attest: C. A. Collier, 

President Jury of Awards. President and Director-General. 

Atlanta, Nov. 1, 1895. 

1896. 

AMERICAN INSTITUTE, NEW YORK-MEDAL FOR 
SUPERIORITY. 
Judge's Report : 

After a full and impartial examination of the articles above described, 
the undersigned Judges make report: 

That the exhibit of A. A. Marks of artificial limbs, and apparatus for 
relief of various deformities, is the most extensive and complete to be 
found within the Fair. 
Special attention is called : 

First. — To the rubber foot with imbedded metallic mattress spring 
combined with the Marks artificial leg. 

Second. — To the flexible fingers on artificial hand, and their great 
adaptability to every day use. . 

Third. — The use of aluminum in place of wood for climatic variations 
seems to be of practical use for those engaged in certain employments. 
Finally, the ingenious combination Knife and Fork for the one 
armed is highly commended. 

Henry T. Peirce, M. D., 
Geo. H. Rich, D. D. S., 

Judges. 
We recommend the award of the Medal of Superiority. 

1897. 

; TENNESSEE CENTENNIAL AND INTERNATIONAL 

EXPOSITION. 

Held at Nashville, Tenn., from May 1st to October 30th, 1897. 

The highest and only award for artificial limbs was a diploma of 
excellence and a silver medal, which were given to A. A. Marks of 
New York. 

The merits that received especial recognition were: Artificial Legs 



384 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK. CITY. 

with Rubber Feet, Adjustable Knee Joints, Artificial Arms with 
Rubber Hands, and a Combination Knife and Fork for one-armed 
persons. 
This makes a total of 29 highest awards received by A. A. Marks. 

1898. 

TRANS-MISSISSIPPI AND INTERNATIONAL 

EXPOSITION. 

Held at Omaha, Neb., from June 1 to November 1, 1898. 

Diploma and Gold Medal awarded to A. A. Marks, 701 Broadway, 
New York. 

Marks' Artificial Legs with Rubber Feet and Artificial Arms with 
Rubber Hands are superior to all others in the following points : 

Excellence of mechanical construction. 

Minimum weight, maximum durability. 

Noiselessness. 

Motions that simulate nature. 

Knee-joints, adjustable and noiseless. 

Suspenders, of variety adaptable to every condition. 

Knee-lock for short and enervated stumps. 

Fittings that permit pressure at points of toleration, avoiding impact 
on the vascular parts, thereby preventing choking of blood vessels. 

Rubber hands with ductile, fingers, most accommodating and possess- 
ing the greatest range of utility. 



At every exhibition, State, national, and international, where these 
artificial limbs have been exhibited, the highest awards have always 
been given. Competition has been large, comprising the productions 
of nearly a hundred establishments, and the Marks artificial limbs 
have always proved peerless. 



PART IV. 

TESTIMONIALS AND COMMENDATIONS. 



WHAT THE DOCTORS SAY. 

We, the undersigned, are professionally interested in the subject of artificial 
limbs. We have witnessed the operation of the rubber hand, foot (or both), 
and acknowledge that they possess exceptional merit. We cheerfully endorse 
them, and give you permission to refer to us in your pamphlet. 

Lewis A. Sayre, M. D., 

285 5th Ave., N. Y. City. 
Consult. Surg. Charity and Bellevue Hosp. 

Geo. F. Shrady, M. D., 

8 East 66th St., N.Y City. 
Consult. Surg. Hosp. Rupt. and Crippled, N. Y. Cancer Hosp. 
Visit. Surg. St. Francis' Hosp. Editor Medical Record. 

R. B. Granger, M. D., 

72 Fifth Ave., N. Y. City. 

The New York Medical Journal. 

Ruel S. Gage, M. D. , 

400 West 22d St., N. Y. City. 

Henry Ruhl, M. D., 

842 East 164th St., N. Y. City. 

D. D. Stevens, M. D., 

252 West 38th St., N. Y. City. 

S. R. Ellison, M. D., 

266 West 43d St., N. Y. City. 

G. M. Edebohls, M. D., 

198 Second Ave., N. Y. City. 

J. W. Metcalf, M. D., 

642 Gates Ave., Brooklyn, % Y. 

J. E. Richardson, M. D., 

125 So. Oxford St., Brooklyn, N. Y. 

F. G. Winter, M. D., 

18 Patchen Ave., Brooklyn, N. Y. 

J. Densmore Potter, M. D., 

Delphi, Onondaga Co., N. Y. 

Geo. C. Hubbard, M. D., 

Tottenville, Richmond Co., N. Y. 

H. D. Brown, M. D., 

Potsdam, St. Lawrence Co., N. Y. 

M. Cavana, M. D., 

Oneida, Madison Co., N. Y. 

Thos. M. Johnson, M. D., 

309 Main St., Buffalo, N. Y. 

A. S. Zabriskie, M. D., 

Suffern, Rockland Co.. N. Y. 

B. A. Watson. A. M., M. D., 

94 Fairview Ave., Jersey Citv, N. J. 
Author of " Amputations arid their Complications." 

387 



388 A. A. MAEKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

Romeo F. Shabert, M. D., 

151 Washington St., Hoboken, N. J. 
Surg. St. Mary's Hosp. 

G. K. Dickinson. M. D., 

63 Wayne St., Jersey City, N. J. 

J. Henry Clark, M. D., 

26 E. Kinney St., Newark, N. J. 
Surg. St. Barnabas' Hosp. 

Jos. W. Taylor, M. D., 

1747 Humboldt Boul., Chicago, 111. 

John L. Taylor, M. D., 

Succasunna, Morris Co., N. J. 

J. W. Silvara, M. D., 

Ringoes, Hunterdon Co., N. J. 

F. H. MlLLIKEN, M. D., 

3614 Walnut St., Philadelphia, Pa. 

B. F. DlLLIARD, M. D., 

East Bangor, Northampton Co., Pa. 

I. C. Gable, M. D., 

26 So. Beaver St., York, York Co., Pa. 

W. P. Snyder, M. D., 

Spring City, Chester Co., Pa. 

A. LeBar, M. D., 

Stroudsburg, Monroe Co., Pa. 

J. M. Strohm, M. D., 

Fredericksburg, Lebanon Co. , Pa. 

Julius Stricker, M. D., 

Marshallton, Chester Co., Pa. 

W. C. Foster, M. D., 

6106 Penn. Ave., Philadelphia, Pa. 

D. C. Waters, M. D., 

Arnot Mines, Arnot, Tioga Co., Pa. 

J. Flnley Bell, M. D., 

Macleary Building, Portland, Ore. 

Henry P. Geib, M. D., 

Stamford, Fairfield Co., Conn. 
Ex. Surg. General, State of Conn. 

Julian N. Parker, M. D., 

So. Manchester, Hartford Co., Conn. 

E. R. Wheeler, M. D., 

Spencer, Worcester Co., Mass. 

F. E. Sanger, M. D., 

Littleton, Grafton Co., N. H. 

B. F. Page, M. D., 

Littleton, Grafton Co., N. H. 

F. P. Gates, M. D , 

Manteo, Dare Co., N. C. 

Jno. D. Myers, M. D., 

Huntington, Cabell Co., W. Va. 

E. C. Goodrich, M. D., 

817 Broad St., Augusta, Richmond Co., Ga. 

J. S. Todd, M. D., 

74 Marietta St., Atlanta, Fulton Co., Ga. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 389 



W. Duncan, M. D., 

Savannah, Ga. 

Thos. J. Charlton, M. D., 
Savannah, Ga. 

J. W. Farill, M. D., 

Farill, Cherokee Co., Ala. 

P. B. Greene, M. D., 

Ft. Payne, De Kalb Co., Ala. 

J. D. Carpenter, M. D., 

Holla, Phelps Co., Mo. 

H. F. Pahl, M. D., 

Brenham, Washington Co., Tex. 

C. L. KlNNAMAN, M. D., 

1463 Cedar Ave., Cleveland, O. 

T. J. Barton, M. D., 

Zanesville, Muskingum Co., O. 

Edmund C. Brush, M. D., 

Zanesville, Muskingum Co., O. 
Surgeon C. & M. V. Ry. Co. and B. Z. & C R. R, 

O. W. Ward, M. D., 

Duncan's Falls, Muskingum Co., O. 

James L. Dickens, M. D., 

La Fontaine, Wabash Co., Ind. 

Chas. L. Wilson, M. D., 

Indianapolis, Ind. 

J. W. Willis, M. D., 

Woodhull, Henry Co., 111. 

J. R. Gamble, M. D., 

Walhonding, Coshocton Co., O. 

M. Cassingham, M. D., 

Gardner, Grundy Co., 111. 

F. B. Strauss, M. D., 

Gibson City, Ford Co., 111. 

C. C. Huckins, M. D., 

Greene, Butler Co. , la. 

J. W. Reed, M. D., 

Lime Springs, Howard Co., la. 

Win Wylie, M. D., 

West Superior, Wis. 

Allen Robert Law, M. D., 
Madison, Wis. 

W. C. Bedford, M. D., 

929 East 15th St., Kansas City, Mo. 

W.D. Little, M. D., 

Zumbro Falls, Wabasha Co., Minn. 

John R. Bailey, M. D., 

Mackinac Island, Mackinac Co., Mich. 

W. T. Dodge, M. D., 

Big Rapids, Mecosta Co., Mich. 

Alfred David, M. D., 

Atlantic Mine, Houghton Co., Mich. 
Physician and Surgeon to the Atlantic Mine Cc. 

H. M. Haskell, M. D., 

Palmer, Marquette Co. , Mich. 



390 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



F. Kelly, M. D., 

Alba, Antrim Co., Mich. 

Geo. A. Kenny, M. D., 

Salmon City, Lemhi Co., Idaho. 
Examining Surgeon for Pensions. 

S. P. Hunt, M. D., 

Salubria, Washington Co., Idaho. 

J. C. Russell, M. D., 

Saranac Lake, Franklin Co., N. Y. 

D. W. Hershey, M. D., 

Nebraska City, Otoe Co., Neb. 

G. H. Simmons, M. D., 

Lincoln, Neb. 

Henry Wisner, M. D., 

Sharon, Barber Co. , Kans. 

Sarah C. Wisner, M. D., 

Sharon, Barber Co. , Kans. 

J. A. Jeannotte, M. D., 

Clyde, Cloud Co., Kans. 

A. G. Saxton, M. D., 

Clyde, Cloud Co., Kans. 

Dan'l K. Dickinson, M. D., 

Lead City, Lawrence Co., Dak. 
Surgeon H. G. M. Co. 

W. H. Taylor, M. D., 

New Market, Jefferson Co. , Tenn. 

Wm. T. Dalby, M. D., 

Salt Lake City, Utah. 
J. S. Courtney, M. D., 

Lebanon, Linn Co., Ore. 
W. F. Anderson, M. D., 

255 Second East Street, Salt Lake City, Utah. 
H. R. Garner, M. D., 

Carbonado, Pierce Co., Wash. 
J. F. Cropp, M. D., 

Walla Walla, Walla Walla Co., Wash. 
C. S. Marshall, M. D., 

Mill Village, Nova Scotia, Canada. - 
I. F. Black, M. D., 

Halifax, Nova Scotia, Canada. 



I have examined with great care Marks' Patent Artificial Limbs, and cheer- 
fully bear testimony as to the simplicity and efficiency of the invention. 

From their peculiar mechanism they perfectly fulfill the purpose for which 
they are intended, and in my opinion have no superior. 

John J. Crane, M. D., 
New York. 



I have had frequent occasion to apply A. A. Marks' most valuable Patent 
Artificial Leg, in cases where I have unfortunately been compelled to mutilate 
my patients by amputation, and the admirable imitation which that substitute 
has given of the original limb, and the perfect satisfaction to the wearer, is the 
highest possible commendation that I can give it. 

Lewis A. Sayre, M. D., 
New York. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW TORK CITY. 391 



Having been well acquainted with Marks' Artificial Limbs and various im- 
provements which have been made for the last ten years, and from the great 
success which has attended the application of his limbs, and the utility of the 
same, I have no hesitation in saying that their accomplishments have not been 
surpassed. 

The ease and facility with which persons move and walk about, and run, as 
it were, is such that in many cases the Artificial Limb cannot be detected. 

Robert S. Newton, M. D., 
New York. 



I have carefully examined Marks' Artificial Limbs, and believe, because of 
their simplicity and strength, that they will be sought for by those wiio may 
be so unfortunate as to require them. 

James R. Wood, M. D. , 

New York. 



I have worn Marks' Patent Leg for the last year. I am well pleased with it. 
It has not required the least repairs. I can walk better with it than any leg I 
ever used, except the natural one. 

I consider Marks' India-Rubber Foot a valuable improvement to Artificial 
Legs. 

W. L. Applet, M. D., 
Cochecton, N. Y. 



It is many years since my son was fitted with one of Marks' Artificial Legs, 
and sufficient time has elapsed to form an opinion as to its merits. 

I think Marks' claim fop " superiority over all others, in practical efficiency, 
simplicity of construction and durability," is well founded, and cannot honestly 
be denied. I will also add that for ease and comfort in use they cannot be 
surpassed. 

W. H. Schenk, M. D., 
Flemington, N. J. 



Having for the last eleven years used in my practice Marks' Patent Artificial 
Limbs, with India-Rubber attachments, I feel it my privilege as well as duty 
to acknowledge my favorable appreciation of them. 

Several of the cases have been under my daily observation, while in pursu- 
ance of their various avocations, the majority being employees of the Central 
Railroad of New Jersey, with which I have been a long time connected as 
surgeon. I will only mention a single case, that of Patrick Liddy, of this 
place, who was supplied with a pair of limbs for the lower extremities. Fortu- 
nately both knee joints had been preserved, and he has since the application 
been able to perform a considerable amount of walking, and usually without 
any cane, regarding it as an encumbrance. 

I may, if desired, by consent of the parties, refer to others having lost one 
lower extremity, who almost or wholly succeed in their natural desire to escape 
observation ; another remark is due, that the India-Rubber Foot does not pro- 
duce that wooden-leg sound so often noticed on the street from less modern 
appliances. I have not yet heard a patient express dissatisfaction, and feel well 
sustained by experience in giving this approval. 

Yours truly, 

J. S. Martin, M. D., 

Elizabethport, N. J. 



In reply to yours of the 26th ult., I can reply that I have purchased Marks' 
Artificial Limbs for patients, and that they invariably have given entire 
satisfaction. 

C. Ewer, 
Asst. Surgeon U. S. A., 
Fort Sidney, Neb. 



392 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



The persons to whom Marks has furnished artificial appliances for amputa- 
tions of the feet (one Symes' and the other Pirogoff's operations) express them- 
selves as being perfectly satisfied. 

The appliances are light, easily applied, and do not produce excoriation or 
tenderness at the end of the stump. 

I consider that Marks' appliances fulfill all the indications called for in pro- 
viding artificial support after amputations. 

Henry P. Geib, M. D., 
Stamford, Conn. 



From my observations since 1882, 1 could give you a more emphatic endorse- 
ment than before. 

C. L. Wilson, M. D., 

Indianapolis, Ind. 



I cheerfully and fully endorse the Marks rubber hands and feet. I have 
several patients using them and with perfect satisfaction. 

Sincerely, 

J. Henry Clark, M. D., 

Newark, N. J. 



In matter of finish, durability, simplicity of construction, completeness of 
action, and perfect adaptation to stump, the Marks artificial limbs are far 
superior to anything I have ever seen. \ 

W. H. Taylor, M. D., 
New Market, Jefferson Co., Tenn. 



I ordered a Marks artificial hand and arm for a patient, and it has given 
good satisfaction. 

J. Finley Bell, M. D., 

Osceola Mills, Pa. 



Brooklyn, N. Y. 
Refer to me as to the merits of the Marks limbs. 

Yours truly, 

J. W. Metcalf, M. D. 



New York. 
I know of no artificial appliance that so nearly simulates nature as those of 
your manufacture. 

R. B. Granger, M. D. 



Delphi, Onondaga Co., N. Y. 
Mrs. K. E. Cardner's leg works to a charm. She can get about without 
even a walking-cane, on the Marks leg. Does her housework without any 
difficulty. 

J. Densmore Potter, M. D. 



I have used the "Marks Artificial Legs" with rubber feet, and they give 
more complete satisfaction than any others I have ever seen. Have one case of 
double amputation (thigh and leg) ; the man walks with ease and comfort 
simply with a cane. 

Jno. D. Myers, M. D., 

Huntington, "W. Va. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 393 



The pair of artificial legs I ordered of A. A. Marks about ten years ago for 
Jno. Nodolf are wearing well and give perfect satisfaction. 

Allen Robert Law, M. D., 

Madison, Wis. 



My bias is very strongly in favor of the solid "Rubber Feet and Hand 
Limbs " manufactured by A. A. Marks, on the grounds of, first and foremost, 
durability; in the case of the foot solidity and firmness of footing, with suffi- 
cient pliability and no side motion, and in the case of the hands pliability. I 
have yet to find the person wearing either who finds any fault, which I cannot 
say in regard to many rattle-traps. 

C. C. Huckins, M. D., 

Greene, la. 



Marks rubber hand has been especially satisfactory, 

W. C. Bedford, M. D., 

Fergus Falls, Minn. 



I have no idea of ever recommending a jointed limb again. Marks rubber 
foot fully meets the wants. 

Jas. Johnston, M. D., 
Sault Ste. Marie, Mich. 



I am pleased to add that the leg I procured from A. A. Marks for my 
patient works to perfection. He does anything that is to be done on a farm, 
and has lately learned to dance. 

H. R. Garner, M. D., 

Carbonado, Wash. 



A. A. Marks makes by all odds the best artificial limb made. I have a 
number of patients wearing the Marks limbs who would not accept any other 
maker's artificial limb as a gift . 

Win Wylie, M. D., 

Wausau, Wis. 



I endorse Marks artificial limbs with pleasure. My associate, Dr. T. I. 
Charlton, who rendered me very valuable assistance in taking the measure- 
ments for the two last artificial legs ordered from A. A. Marks, also endorses 
them. 

No complaint has been made to me by any persons for whom I have pro- 
cured the Marks artificial limbs, and they seem fully adapted for all that is 
required of them. 

W. Duncan, M. D., 

Savannah, Ga. 



The endorsement of patent articles, of whatsoever kind and description, is 
something I very seldom do, but the Marks artificial limbs with rubber hands 
and feet meet my unqualified approval, as being the best I have ever had 
occasion to recommend to those desiring artificial limbs. 

J. R. Gamble, M. D., 

Blandinsville, 111. 



> I have had various opportunities of testing the merits of the Marks artificial 
limbs with rubber hands and feet, and can cheerfully recommend them to be 
superior in every respect to any other which has come under my observation. 
and that the operation of your rubber hand and foot will prove to possess 
exceptional merit to any who will try their virtues. 

Wm. T. Dalby, M.D., 

St. John, Ariz. 



394 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



I have ordered several of the Marks artificial limbs for patients who had lost 
their limbs above and below the knee, and in every instance they have given 
perfect satisfaction. 

D. K. Dickinson, M. D., 
Surg. H. G. M. Co., 
Lead City, S. Dak. 



I have bought a Marks arm. In a few months shall call on A. A. Marks 
for a leg. 

D. C. Waters, M. D., 

Arnot, Pa. 



Littleton, Grafton Co., N. H. 
The leg bought of A. A. Marks is perfectly satisfactory. 

F. E. Sanger, M. D., 
B. F. Page, M. D. 



I have recommended the A. A. Marks very valuable patent artificial limbs 
to a number of my patients, who are wearing them with perfect satisfaction, 
and I have no hesitancy in saying in my judgment they fulfill their purpose 
better than any others that have come under my observation. 

I. C. Gable, M. D., 

York, Pa. 



My leg is satisfactory ; with much pleasure I commend the Marks work to 
others. 

Dr. William G. Schafhirt, 

Washington, D. C. 



I have experienced the worth of the A. A. Marks artificial arm, and would 
say it is a perfect Godsend and worth its weight in gold. 

J. W. Farill, M. D., 

Farill, Ala. 



I thoroughly believe the Marks make of limbs with rubber hands and feet 
are superior to any other make. 

The leg purchased by me for Miss Aggie Holland is giving good satisfaction. 
I can heartily recommend the Marks make of artificial limbs. 

Yours truly, 

C. S. Marshall, M. D., 

Mill Village, N. S., Canada. 



The artificial leg that A. A. Marks made for a patient of mine, a boy ten 
years of age, is perfect in every particular, and the ease and grace with which 
he runs about and uses it is remarkable. 

Amputation was performed October 25. November 29 the boy was sliding 
on the ice with his playmates. January 10 the boy was • skating, with 
practically no inconvenience whatsoever. I think the Marks limb one of the 
greatest boons to unfortunate humanity that exist. 

J. C. Kussell, M. D., 

Saranac Lake, N. Y. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 395 



WHAT THE WEARERS SAY. 
ALABAMA. 

ABOVE-ELBOW AMPUTATION. 

Fitted from Measurements. 

Cherokee County, Ala., Jan. 1, 1896. 
I am wearing one of A. A. Marks' artificial arms, and am much pleased with 
it, and would say that it is all he claims for it. 

Miss Mary Cumby. 
Endorsed by J. W. Farill, M. D. 



ANKLE-JOINT AMPUTATION— ALUMINUM SOCKET. 

Dec. 30, 1895. 
A. A. Marks, Esq. : 

Dear Sir : — After using one of your " new aluminum " legs for " Chopart's 
amputation " about four years, I am convinced that they are the best made for 
such amputations. They are as you say, strong, light, neat, and very efficient. 
I recommend their use to all needing such a leg. 

I remain, 

Very respectfully yours, 

J. D. Sutton. 
Mobile, Ala. 



ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Talladega County, Ala. , July 6, 1896. 
Mr. A. A. Marks : 

Dear Sir : — I have been using one of your legs for nearly ten years ; I find 
it all that could be expected. I have a five-inch stump only, and have been 
working for different railroads for eight years, as station agent and operator. 
I never use a stick or crutch, can walk extra well for one having so short a 
stump. I am, 

Very truly yours, 

J. E. Jolly. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Chilton County, Ala., March 7, 1896. 
Mr. A. A. Marks : 

Dear Sin : — I received my leg November 4, found it in good order, and a 
good fit. I am well pleased with the change to rubber foot ; think it well worth 
what it cost. Success to your patent foot ; it is a great improvement. 

Yours respectfully, 

J. A. Propst. 



396 A. A. MARKS, ARTIFICIAL LIMBS, NEW YOEK CITY. 



ARIZONA. 

ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Graham County, Ariz., Feb. 11, 1887. 
A. A. Marks, Esq. : 

Sir : — I am very much pleased with the cork leg you sent me. I am around 
daily without the assistance of a stick, and can ride horseback as well as ever. 
I get around just as fast as if I had both natural legs. 
You can hardly tell the difference in my walk. 
The stump has never been sore since I have been using the leg 

Respectfully, etc., 

Edward Scott. 



ABOVE-KNEE AMPUTATION! 

Fitted from Measurements. 

Mohave County, Ariz., Aug. 13, 1894. 
Mr. A. A. Marks: 

Dear Sir : — The leg I ordered for Mr. Sorrensen three years ago was all 
that could be desired, and if you succeed in giving my other patients as ser- 
viceable limbs as that man, you will do all that could be desired. 

Yours very truly, 

R. B. Knight, M. D. 



Maricopa County, Ariz., Oct. 9, 1894. 
Mr. A. A. Marks: 

Dear Sir : — The foot you placed on my old ankle-joint leg is all right, and 
gives perfect satisfaction. 

Yours truly, 

Roy Frankenberg. 



ARKANSAS. 



BOTH LEGS AMPUTATED. ONE ABOVE THE KNEE AND THE 
OTHER BELOW. 

Hempstead County, Ark., Dec. 12, 1887. 
To Whom Concerned :— On the 13th of January, 1884, 1 had the misfortune 
to lose both my legs in a railway accident, one four inches above, the other 
three and one-half inches below the knee. The following October I applied a 
pair of A. A. Marks' artificial limbs with rubber feet, which enabled me to 
walk with but little difficulty, with only the use of one cane, and without that 
when walking about the office. 

The rubber feet prevent an unnatural sound while walking on the floor ; 
also prevent the uncomfortable jarring of the stumps which is experienced in 
the wooden feet of other manufacturers. 

Yours respectfully, 

D. M. Alktre. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 397 

BOTH LEGS AMPUTATED AT THE ANKLE JOINTS. 

Fitted from Measurements. 

Garland County, Ark., Dec. 17, 1895. 
A. A. Marks, Esq. , New York : 

' Dear Sir : — I lost both my limbs from frost bite in November, 1880, and 
since that time I have been wearing your patent rubber foot. I am now a 
much larger man than when I first wore the limbs; it gives me pleasure to state 
that I have no difficulty in attending to my duties, which are as laborious as 
those of most any„man with no bodily infirmities. I weigh about two hundred 
pounds. It is a surprise of the most remarkable kind among my friends here 
to see the way I get about after knowing my misfortune, frone of them dream 
of such a thing unless I tell them, and I think you yourself would doubt the 
condition of my limbs if you were to see me going around among other people. 
I stand amazed at your own ingenuity and capability of making maimed 
whole. 

Very truly, your patron, 

G. W. Tatum. 



BELOW-ELBOW AMPUTATION. 

Fitted from Measurements. 

Jefferson County, Ark., Nov. 14, 1887. 
Mr. A. A. Marks, New York City : 

Dear Sir : — The arm I ordered of you last April gives perfect satisfaction. 
The rubber hand is immense. I do not think there could be anything gotten 
up to equal it. It looks perfectly natural ; in fact, some of my friends did not 
know that I had lost my arm. Being a machinist and engineer, it enables me 
to follow my profession as ever. I can file, hold the chisel, hold the reins to 
ride or drive, cut my own meats, and many things that one would not believe 
could be done with an artificial arm. I have seen several kinds of artificial 
arms, but none to equal yours with rubber hand. It is very durable, easily 
adjusted, and soft to the touch. I can write very well with it, though I do not 
as a general thing use it for that purpose. The hook attachment is very val- 
uable in doing rough work. I would advise those that have to wear artificial 
limbs to give you a trial before purchasing elsewhere. 

Yours truly, 

W. E. Snipes. 



CALIFORNIA. 
BOTH LEGS AMPUTATED BELOW THE KNEES. 

Fitted from Measurements. 

Alameda County, Cal., Dec. 18, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I take great pleasure in testifying to the merits of your artificial 
limbs. I have used them for about eleven years. 

They were fitted from measurements. I have worn them constantly without 
any trouble. I am by profession a lawyer. 
In my opinion your legs are the best made. 

Yours sincerely, 

S. B. McKee. 



ABOVE-KNEE AMPUTATION. 

Santa Clara County, Cal., Dec. 30, 1895. 
Mr. A. A. Marks : 
Dear Sir :— Larger experience has only served to make me more satisfied 



398 A. A. MARKS, ARTIFICIAL LIMBS, NEW TORK CITY. 



with the work that you have done for me. The especial points that have 
given me satisfaction are three — viz.: the leg fits well, it makes no noise, and 
needs no repairs. 

Truly yours, 

R. B. Peet, Rector. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

San Bernardino County, Cal., Dec. 26, 1895. 
A. A. Marks, New York : 

Dear Sir : — My son, John Jerome Booth, aged eighteen years, who had the 
misfortune to loose a foot about thirteen years ago, has used one of your 
artificial limbs for the past twelve years with complete satisfaction. Soon after 

procuring the Marks' limb I concluded to try , and for that purpose ordered 

one with lateral motion. Here, then, I had a fair opportunity for competitive 
trial. As a result, the leg was returned for repairs in six months, while the 
Marks' was never returned except for lengthening. The son runs, jumps, 
climbs, and skates as well as any of his companions, and the closest observers, 
when informed of his misfortune, are at a loss to determine which is the real 
and which the artificial limb. 

Your obedient servant, 

James P. Booth, M. D.,* 

Surgeon A. & P. R. R. Co. 



BELOW-KNEE AMPUTATION. 
Fitted from Measurements. 

San Diego County, Cal., Dec. 20, 1895. 
A. A. Marks : 

Dear Sir : — Having been a wearer, for the last fourteen years, of one of 
your artificial limbs with rubber foot attached, I wish to say that in lightness 
and durability your limbs are unparalleled. 
My own, I am using yet, will last me for a good time to come. 
My position as Deputy County Treasurer requires standing on my feet the 
most of the time, and very much walking from desk to desk. 
I have used artificial limbs for twenty-one years, but your make is the best. 

Very truly yours, 

Otto Foster. 



BELOW-KNEE AMPUTATION. 

Mar. 9, 1895. 
A. A. Marks : 
Dear Sir : — I purchased a leg from you in 1863, before you used the rubber 

foot, and since then I have worn the leg, and the leg, and, as you 

know, I have used the rubber foot a great deal of the time, since you intro- 
duced it in the market. It is far ahead of any leg that I have worn, for 
durability and economy, and I always feel safe when wearing it, as there are 
no springs or cords to break, no squeaking or clattering sound to attract the 
notice of the people as I pass by, and there is nothing to oil, except the knee- 
joints, which can be done in a few moments, and then my mind is easy, so far 
as the leg is concerned, for the next two or three days. As for repairs, I 
would state that I have worn the rubber foot for a straight seven years without 
spending a nickel on it. My leg is amputated about four inches below the 
knee, and my occupation is a clerk. 
I do considerable walking every day. 

Respectfully yours, 

Thomas Gibson. 
San Francisco, Cal. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 399 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Tehama County, Cal., Dec. 22, 1895. 
A. A. Marks": 

Dear Sir: — My leg was amputated about three inches above the ankle- 
joint. I have worn an artificial leg made by you for more than eleven years. 
It has given me entire satisfaction, inasmuch as I am enabled to attend to all 
my former duties without interruption. I frequently -follow a plow all day, 
often twenty miles, run'a header, and do other such arduous work. 

J. T. Stillwell. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Tulare County, Cal., Dec. 2, 1895. 
A. A. Marks : 

Dear Sir : — The leg and foot that you sent for my son in 1876 lasted 
remarkably well for such an energetic fellow; hardly still a moment, when 
he goes he will get there as soon as the best of them. The limb performed to 
satisfaction in every respect. 

Respectfully, 

Wm. Thomson. 



ANKLE-JOINT AMPUTATION. 

Fitted from Measurements. 

Orange County, Cal., Dec. 20, 1895. 
A. A. Marks : 

Dear Sir : — I am getting along nicely with my leg. It was a good fit and 
works all O. K. 

Yours respectfully, 

Ed. Tedford. 



BELOW-ELBOW AMPUTATION. 

Fitted from Measurements. 

* Santa Clara County, Cal., Dec. 24, 1895. 

A. A. Marks : 

Dear Sir : — My left hand is off just above the wrist. A little over ten 
years ago I had one of your artificial hands made from measurements and have 
worn it every day since. 

It fits perfectly, and, were it not for the glove, could not be distinguished 
from the natural hand. I find it very useful, and if compelled to, could 
learn to write with it. 

Yours truly, 

Charles Hammond. 



WRIST AMPUTATION. 

Fitted from Measurements. 

Santa Clara County, Cal., Dec. 24, 1895. 
A. A. Marks : 

Dear Sir : — I have been using one of your most valuable artificial rubber 
hands. I am greatly pleased with it. I have had it for one year, and I can 
use a knife and fork, carry a satchel, etc. My occupation is engine-driving. 
My hand was cut off at the wrist. 

I am, respectfully, 

Thomas Tonkin. 



400 A. A. MAEKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



COLORADO. 

ABOVE-KNEE AMPUTATION. 

Lake County, Col., Dec. 20, 1895. 
Mr. A. A. Marks : 

Dear Sir :— I have worn limbs of your patent over twenty years, and I 
think none that are made will compare with yours. 

I wore three other kinds before getting yours. All the first three had ankle 
joints that kept me busy repairing. Since I have been wearing yours I have 
no repairing to do. I am running a ranch, digging sage brush, and all other 
kinds of rough work. 

Respectfully yours, 

W. H. Royston. 



ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Pueblo, Col., Dec. 5, 1895. 
A. A. Marks, New York City : 

Dear Sir; — I purchased my artificial leg of you ten years ago. I have 
nothing but praise to offer. You followed my measurements in making it 
with such exactness that I can't see how it could fit better if I had gone to 
New York in person. 

I am farming out here, and can harrow, mow, and do all manner of farm 
work, although my stump is but eight inches long. 

The rubber foot is especially serviceable in that kind of work, as it is elastic 
enough, and has stability. 

Yours very truly, 

Thomas Barber, Jr. 



BELOW-KNEE AMPUTATION. 

Denver, Col., Dec. 17, 1895. 
A. A. Marks : 

Dear Sir : — After examining the different kinds of limbs I could see or hear 
of in the United States, and some from Europe, I secured one of yours, and 
have continued in its use ever since. 

During the past thirty years I have traveled around considerable, and met 
persons wearing all kinds of legs, but I have yet to see the colors of the banners 
of those that can walk better than I can, if they use any other limb than yours. 
Your limbs have given me perfect satisfaction, combining, as they do, easy, 
comfortable, graceful, and natural motion and durability. 

Yours very truly, 

Richard McCloy. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Fremont County, Col., Dec. 17, 1895. 
Me. Marks : 

Dear Sir :— I have worn the artificial leg you made for me, in the mines, 
and could get along as well as any of the other miners. I have worn other 
styles of legs, but I find yours to be much better. There is another party here 
using your leg, and he walks splendidly with it. 

Respectfully yours, 

Wm. Masters. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



401 



BOTH LEGS AMPUTATED BELOW KNEE. 

Fitted from Measurements. 

Arapahoe County, Col., Aug. 3, 1893. 

A. A. Marks : 

Dear Sir : — I received my limbs July 31, and put them on at once. Wore 
them that evening and all the following day, working in the store from six 
o'clock in the morning until ten o'clock at night. I must say that I am well 




pleased with the limbs. The fittings are as good as could be made under any 
circumstances. My limbs are lighter than I expected, as I wrote you in 
ordering them that I wanted them extra strong, as my work was heavy. 
They seem to have the requisite strength. 

E. B. Scull. 



CONNECTICUT. 

BOTH LEGS AMPUTATED. ONE AT THE ANKLE, THE OTHER 
BELOW THE KNEE. 

Dec. 16, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I wish to say this is to certify that I have had constantly in use 
two of Mr. A. A. Marks' patent artificial limbs since 1S78, and I am glad to 
state they have come up to my greatest expectations. 

I am in the oyster business, and have not lost any time on account of wear- 
ing two artificial limbs. During my seventeen years of experience on artificial 
limbs, I have worked hard fifteen years at the oyster business, doing the raking 
myself. I have had but very little repairing done. 

Yours respectfully, 
Fairfield County, Conn. Albert W. Mills. 

(Illustrated on page 137.) 



402 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



FATHER AND SON— THE FORMER ABOVE THE KNEE, AND THE 
LATTER BELOW THE KNEE. 

Bridgeport, Conn., Dec. 16, 1895. 
Mr. Marks : 

Dear Sir : — I am glad to say your limb has given me great comfort and 
much satisfaction. 

There is a saying, " It runs in the family." The wooden leg mania seems to 
have no exception. My boy Willie was ten years old when he lost his foot by 
the cars on the N. Y., N. H. & H. R. R. The amputation was made three 
inches below the knee. 

He runs and jumps on the trains, and is as active as anyone with the 
naturals. He is frequently asked if it was not his brother that lost his leg. 
Through your great invention he is almost able to forget his misfortune. 
Willie says there is no one in the world that makes as noiseless a limb as you 
do. He and I both agree that your legs with rubber feet are without equals 
to build a poor fellow up after he has been mashed to pieces. 

Respectfully, 

Patrick Bray. 
W. J. Bray. 



ABOVE-KNEE AMPUTATION. 



Dec. 16, 1895. 



Mr. A. A. Marks: 

Having been using one of your artificial limbs for some time I feel quite 
pleased with it, and would always recommend them to anyone in need of 
such. I lost a leg about nineteen years ago by a running sore, and have only 
six inches of stump left. I do not think the rubber foot has any equal. 

Matthew Whelan. 

Litchfield County, Conn. 



ABOVE-KNEE AMPUTATION. 

Litchfield County, Conn., Dec. 16, 1895. 
Mr. Marks : 

Kind Friend : — I have worn your artificial limbs from childhood up. 
I can truthfully speak of their merits. I have worn a limb with a rubber foot 
for thirty years and doing ordinary housework. 

Respectfully yours, 

Mrs. A. C. Fleezer. 



ABOVE-KNEE AMPUTATION. 

Bridgeport, Conn., Jan. 2, 1896. 
Mr. A. A. Marks : 

Dear Sir : — In May, 1882, I was so unfortunate as to lose my right leg 
above knee. In September, 1882, I was advised to procure one of your patent 
artificial limbs with rubber foot. 

It now gives me sincere pleasure to be able to inform you that the artificial 
leg which you made for me has more than realized my expectations. The 
durability of your patent has, I think, been fully established. The foot 
appears to be as good now as when I first commenced to wear it. 
I cheerfully recommend your legs to all needing them. 

I remain, dear sir, 

Leonard Manz. 



ABOVE-KNEE AMPUTATION. 

New Haven County, Conn., Dec. 13, 1895. 
A. A. Marks, Esq. : 

Dear Sir : — The limb which I purchased from you eight years ago is giving 
entire satisfaction, and is in every way as recommended. 

Most respectfully yours, 

John Daly. 



A. A. MAEKS, ARTIFICIAL LIMBS, NEW TOEK CITY. 403 

KNEE-BEARING AMPUTATION. 

Dec. 16, 1895. 
A. A. Marks, New York : 

Dear Sir :— I have worn one of your legs fifteen years continuously. I can- 
not express my delight in having found so great a treasure. 

I am, respectfully yours, 
Fairfield County, Conn. William Hickerson. 



BELOW-KNEE AMPUTATION. 

Bridgeport, Conn., Dec. 17, 1895. 
A. A. Marks : 

Dear Sir : — I have been wearing your patent artificial leg for the past 
twenty-three years ; I had previously worn others, but they were not satis- 
factory. In my opinion, your leg is far superior to any other artificial leg 
made. First, because of its ease, elasticity, and stillness ; these are obtained 
by the use of the rubber foot, and I think it is the only sensible thing to use 
for this purpose. Second, because of their durability, which is no small item. 
I am in the insurance and real estate business, and am continually on the go. 
There are few who walk as much as I do. My leg is amputated four and a 
half inches below the knee. 

Yours very truly, 

A. E. Bartram. 



BELOW-KNEE AMPUTATION. 

Bridgeport, Conn., Dec. 18, 1895. 
A. A. Marks : 

Dear Sir : — On February 3, 1887, I purchased an artificial leg from you. 
In four days after I commenced work on steamer Rosedale. I am on my feet 
from 6.30 a. m. to 7.30 p. m. daily. I have lost no time, neither have I 
experienced any inconvenience in the use of it. I have not spent anything 
for repairs, and it remains the same as when purchased. My leg was 
amputated one and one-half inches below the knee. 

Yours truly, 

Conrad Prutting. 



BELOW-KNEE AMPUTATION. 

Fairfield County, Conn., Dec. 18, 1895. 
A. A. Marks, Esq. : 

Dear Sir : — The artificial limb that I have from you I have worn continu- 
ally for thirteen years. I think that the rubber foot is a great improvement. 

Respectfully yours. 

Frederick A. Scofield. 



BELOW-KNEE AMPUTATION. 

Litchfield County, Conn., Dec. 17, 1895. 
A. A. Marks, Esq. : 

Dear Sir :— In 1864 I lost my leg by amputation below the knee. In 1865 
I procured, as I supposed, one of the best artificial legs in use, the wearing of 
which gave me much pain, and I was often obliged to go back on crutches 
until the irritated and swollen stump was again in condition to wear the leg. 
It also annoyed me very much by frequent rattling of the ankle joint. Repair 
bills were from $6 to $8 a year. I was obliged to use a cane when walking, 
and walk only when obliged to do so. I wore this leg about two years. I 
met a great many wearing artificial legs made by various firms, all of whom 
were laboring under difficulties similar to my own. I think it was in 1867 
or 1868, while in Watertown, N. Y., I met a gentleman wearing one of 
your artificial legs with rubber foot. I was surprised to see this man go up 
and down stairs actually on a run. He also moved about among the guests at 
the hotel noiselessly and quietly, with the grace and ease of natural motion. 
I have forgotten the name of this gentleman, who advised me to get one of 
your artificial legs with rubber foot. I at once wrote to- you, requesting you 
to send me instructions and blanks for taking measurements. 



404 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



I received a prompt reply, and ordered a leg. I have worn your legs con- 
stantly from the time I first received one, never having lost an hour's time 
from its use. 

I go up and down stairs, up and down hill, through the brush, hunting and 
fishing. In fact, I go when and where I please with ease and comfort. 

Very respectfully, 

E. A. Nellis. 



BELOW-KNEE AMPUTATION. 



Dec. 23, 1895. 



A. A. Marks, New York: 

Dear Sir :— In August 29, 1884, I lost my right foot. I made a careful 
study of artificial limbs of different makes, and with advice of my doctor 
selected yours. I applied it on the 1st of December, thirteen wee^s after 
amputation, and in a short time I was able to walk so well that hardly anyone 
knew I had lost my foot. 

I work and do all my business now with all ease possible for anyone with a 
false limb, and feel as well as ever. 

Very truly yours, 

Middlesex County, Conn. Lucius J. Stevens. 



ANKLE-JOINT AMPUTATION. 

Hartford, Conn., Dec. 16, 1895. 
Dear Sir : — In reply to your letter, I think your feet are the best in the 
world. I have worn mine for over eight years, and have been to dances and 
a good many social gatherings. I have worn one of the New Haven man's 
feet/and I could not find the comfort I do with yours. Your feet give more 
support to the ankle than any other I have seen. 

Yours truly, 

Eugene D. Fox. 



No. 799 EXTENSION. 

New Haven, Conn., Dec. 16, 1895. 
A. A. Marks : 

Dear Sir : — The extension with rubber foot manufactured for me has been 
in constant use for nine years. I can recommend it for durability, neatness, 
and a comfort that a person with a shortened limb should not be without. 
Not being able to do you justice enough for the comfort that I have derived 
from it, 

I remain, respectfully yours, 

W. C. A. 



No. 784 LEG. 

Windham County, Conn., Dec. 16, 1895. 
Mr. Marks : 

Dear Sir :— I am very much pleased with the apparatus (with rubber foot) 
that you fitted to my deformed foot. I have worn it nine years, and think 
more and more of it. I would not take any amount for it if I could not 
get another. 
I am in a millinery store, and am standing part of the time. 

Respectfully yours, 

Miss H. S. Kennedy. 



A. A. MAEKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



405 



BELOW-KNEE AMPUTATION. 

New Haven County, Conn., June 12, 1894. 

Mr. A. A. Marks, New York : 

Dear Sir : — When I met with the misfortune of losing my right leg, I felt 
that all the sunshine had passed from my life. Fortunately I came in posses- 
sion of a copy of one of your books, and as I perused its pages, I received 
much encouragement. Some tried to dissuade me from entertaining the hope 
of obtaining an artificial leg inside of four or five months, but I was so deter- 
mined to get about on two legs again I procured an artificial leg from you in 
exactly nine weeks after my natural leg was amputated. Five days after I 
received the leg my doctor observed me skating on the canal. He stopped 
and watched me ; he was amazed ; he told me that I beat anything he had 
ever seen. 

I was a professional tight rope walker and aeronaut before I lost my leg, and 




No. 1207. 

I do not propose to allow the loss of a leg to compel me to seek another occupa- 
pation. I can walk a tight rope nearly as well as I ever could. The rubber 
foot enables me to balance with safety. The absence of an ankle joint removes 
the risk of falling to a large degree. I can walk a tight rope while it is fifty 
feet above the ground, and when I am dressed, without exposing my limbs, no 
one would suspect that one of my legs was artificial. 

While walking on the ground I never feel the necessity of looking for uneven 
or bad places. I feel safe and sure on my rubber foot, no matter where I 
place it. I consider your invention of the rubber foot the most valuable and 
important, to persons who have lost their natural limbs, of any invention that 
has been made. 

Respectfully yours, 

Prof. F. E. Jacoby. 



Note.— The above cut (No. 1207) has been made from an instantaneous 
photograph taken of Professor Jacoby while performing on a tight rope. In 
the cut he is balancing entirely on his artificial leg ; his natural foot is off the 
rope and is in the act of passing forward to take the next step, 



406 A. A. MARKS, ARTIFICIAL LIMBS, NEW YOEK CITY. 



DELAWARE. 

BELOW-ELBOW AMPUTATION. 

Fitted from Measurements. 

Wilmington, Del., May 25, 1894. 
A. A. Marks : 

Dear Sm : — I use the arm you made for me for all sorts of work. I cannot 
do without it. I am, 

Respectfully yours, 

Daniel Bord. 



ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Newcastle County, Del. , Jan. 20, 1893. 
Mr. A. A. Marks : 

Dear Sir : — My leg has proved satisfactory for the year that I have worn it. 
I can do anything at all, and I feel that I cannot thank you enough for it. 
I remain, 

Yours truly, 

George Butler. 



DISTRICT OF COLUMBIA. 

ARM AMPUTATED. 

Washington, D. C, Dec. 18, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I desire to say that in 1883 I was unfortunate enough to lose 
my left hand by the bursting of an overcharged gun. The member was 
shattered, and amputation resulted at the wrist joint. Shortly thereafter I for- 
warded to you measurements taken in this city, for one of your artificial 
hands, which arrived in due season, and which I have worn regularly since. 
It has indeed proved a most serviceable and valuable acquisition to me, both 
in use and appearance ; it has lasted me most faithfully all these years — twelve 
in number — and even at this moment it is most convenient to me in holding 
the paper upon which I write. Very light weight, most durable, and not at 
all uncomfortable while worn, its workmanship and construction are a monu- 
ment to the ingenuity of the inventor and manufacturer. 
Very respectfully yours, 

Robert E. Mattingly. 



ABOVE-KNEE AMPUTATION. 

Washington, D. C, Dec. 21, 1895. 
A. A. Marks, New York City : 

My Dear Sir : — I lost my leg in front of Atlanta, in July, 1864. Fifteen 
years later I got one of your rubber-foot legs. I was then mining and smelt- 
ing at Bonanza City, N. M., and the leg gave good satisfaction in that rough 
business and rough country. In 1881 I entered Uncle Sam's service, and since 
that time have traveled over most of our territory, part of the Rocky Mountains, 
going in all kinds of weather, and in every conceivable conveyance, and I 
have found your leg much better than you recommended it. The first leg 
I got in 1880 never had a cent's worth of repairs on it during the five years I 
wore it, and is now laid away ready for use in case of an emergency. The 
one you made me ten years ago bids fair to equal the old one. I walk several 
miles each day without any fear of a break-down, and without that unpleasant 
dead thud that follows that step of a wooden foot on a plank sidewalk or bare 
floor. 

Very respectfully, 

Melville Davis. 



A. A. MAKKS, ARTIFICIAL LIMBS, NEW YORK CITY. 407 



ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Washington, D. C. 
A. A. Marks, Esq : 

Sir : — I am happy to say that I am very much pleased with the cork leg you 
sent me. I am around daily without the assistance of a stick, and can ride 
horseback as well as ever. 
I get around just as fast as if I had both natural legs. 

You can hardly tell the difference in my walk. After using it about a month 
the stump decreased about a quarter of an inch. 

I use nothing but the socks. The stump has never been sore since I have 
been using the leg. 

Respectfully, etc., 

Edward Scott. 



ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Washington, D. C, Dec. 16, 1895. 
. A. Marks, New York: 

Dear Sir: — I had tried four different make of limbs before I procured yours, 
and your limb with rubber foot is the only one that has given satisfaction. 

I have given it a fair test for over ten years. The principal advantage of 
your make over all others is its simple construction; no cords or ankle-joint to 
break, which causes me to feel perfectly safe in using it. I am considered 
hard on a limb.; my friends frequently remark that I get round on it as if I 
had not lost a leg. I weigh 154 pounds, and have what is called an upper' 
thigh amputation, and my duties here require me to be on my feet an aver- 
age of twelve hours a day. 

Respectfully, 

Jno. T. Brady. 



ABOVE-KNEE AMPUTATIONS. 

Dec. 16, 1895. 
My Dear Mr. Marks : 

I know whereof I speak, not only having had an experience of nearly thirty 
years in wearing an artificial leg, but also being a close and interested observer 
of the work turned out by other manufacturers in this branch of industry, and 
my experience and observation lead me to the conclusion that for comfort, 
durability, and the many advantages (including the slight expense of repairs) 
arising from simplicity of construction, yours are pre-eminently the limbs for 
those so unfortunate as to need an artificial for the natural limb. 

Yours very faithfully, 

William Griffin. 

Washington, D. C. i 



ABOVE-KNEE AMPUTATION. 
Applied when a Mere Child. 

Jan. 1, 1896. 
Mr. A. A. Marks, New York : 

Dear Sir : — I desire to offer you a slight testimonial of my gratitude for the 
comfort that my daughter has derived from the use of the artificial leg which 
you adjusted for her in May, 1882, and to_say here, that no one should ever 
hesitate to have a limb adjusted in. childhood, as it is by far the best plan. 
though many persons advise cripples to wait until they have attained their 
growth. My daughter lost her leg in 1879, about three months prior to her 
sixth birthday, and she has worn the artificial leg made by you constantly since 
1883. 

She is a powerful child in frame, and when her leg was removed no hopes 



408 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



■were held forth that she would ever -be able to wear an artificial limb, owing to 
the amputatfbn being made so close to the hip joint. The case is considered a 
remarkable one, and your success in adjusting a leg satisfactorily to so short 
a stump speaks volumes for your work, which cannot be surpassed ; and not 
only has the leg given absolute comfort to the child, but she has grown to 
womanhood, and developed to large and graceful proportions. 
Ever gratefully yours, 

Maggie V. Benner. 
"Washington, D. C. 



KNEE-BEARING AMPUTATION. 

Washington, D. C, Dec. 16, 1895. 
A. A. Marks, Esq.: 

Dear Sir: — Your leg made for me twenty-two years ago I am wearing yet; 
it has given the best satisfaction. 
I have worn it continually and it is in good order yet. 
If I should want another leg I would send to you and get it. 
I am on the road continually, and have given my leg some pretty hard trials. 

Yours very respectfully, 

Heman Blodgett. 



BELOW-KNEE AMPUTATION. 

Washington, D. C., Dec. 16, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I knew nothing of your leg until about 1868. I had then used 
two legs of different makes. One did not answer at all. 

The other I took to you, and had a rubber foot put on, and was so well 
pleased with the change that I have ever since used your leg. My experience 
indicates that your foot is superior in durability, at least to those I have tried. 
In my judgment, its great merits are its simplicity, durability, and its elasticity. 

Yours truly, 

E. Catlin, 
Late Capt. 5th U. S. Art. 



FLORIDA. 
LEG ABOVE KNEE. 

Polk County, Fla., Dec. 19, 1895. 
Have worn artificial limbs for many years with an amputation two inches 
above the knee. Have been constantly working as housekeeper and clerk in 
grocery store during this time. , 

For nearly eleven years I have been wearing a limb made by you with rubber 
foot. I find it durable, noiseless, and light, needing no repairs. My limb is 
superior in every way to any I have tried. 

Mrs. F. A. K. Harris. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Columbia County, Fla., Dec. 16, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I have been wearing an artificial leg of different make for over 
twenty-eight years, and I prefer yours to any I have ever worn. I especially 
like the rubber foot, as there is no rattling and squeaking, so disagreeable to 
sensitive ears, and there is plenty of elasticity. I have been wearing one of 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 409 



yours now for the last twelve years. It was fitted from measurements taken 
by myself with instructions furnished on blank form from you. 
My leg is amputated two inches below the knee-pan. 
My occupation is general farming, which I superintend and direct myself. 

Respectfully, 

T. W. Getzen. 



BELOW-KNEE AMPUTATION. 

Leon County, Fla., Dec. 17, J.895. 
Doctor A. A. Marks : 

Dear Sir:— In July, 1863, I lost a foot at the battle of Gettysburg, Pa., am- 
putation just above the ankle. In 1876 I purchased one of your limbs with a 
rubber foot, having previously worn three of other manufacturers. I there- 
fore claim to be in a position to judge as to who is the best maker of artificial 
limbs. 

I unhesitatingly pronounce your artificial limbs the best I have ever seen. 

My occupation is that of a cotton commission merchant, and am forced to do 
a great deal of outdoor work. I have often been told by acquaintances of ten 
years' standing that they had known me for some time and had only lately 
discovered that I was the wearer of an artificial limb, and then had to be told 
first of the fact. 

Very truly, 

John Day Perkins. 



GEORGIA. 

BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Coweta County, Ga., Dec. 17, 1895. 
Mr. A. A. Marks: 

I have used one of your artificial legs with rubber foot for ten years. It is 
one of the best inventions of the kind. I can do anything with this leg. After 
ten days it became natural to me ; it never troubles me any more. 

C. L. Cook. 



LEG ABOVE KNEE. 

Fitted from Measurements. 

Marion County, Ga., Dec. 20, 1895. 
A. A. Marks, New York : 

Dear Sir: — I do not know how to give you a stronger indorsement of the 
superiority of your limbs than to say I have used them constantly for more 
than twenty years. 

I lost my leg at the second battle of Manassas, in 1862, and for several years 
after I got well I used several other makes before I procured one of yours. 
Since then I have worn your make exclusively. During this long term of 
years I have had many business transactions with you, and it is a pleasure for 
me to express the uniform fairness which has characterized your dealings. 

Yours truly, 

Jas. M. Lowe. 



KNEE-BEARING AMPUTATION. 
Fitted from Measurements. 

Savannah, Ga., Aug. 19, 1893. 
Mr. A. A. Marks : 

Dear Sir : — I have been wearing one of your legs for the last nine years 
and have been much pleased with it ; I have found it one of the greatest bless- 



410 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



ings this world can afford to a cripple as I am. In three weeks from the day 
my leg was amputated, I sent to you and had an artificial leg made, and 
when I received it, I was walking without the aid of anything in less than 
a day. I do all my mother's housework. I still remain, 

Yours truly, 

Sarah Houston. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 



Jan. 4, 



Mr. A. A. Marks : 

Dear Sir : — I wore a leg fifteen years and liked it well. Sixteen years ago 
I got one of yours and liked it a great deal better. If I knew 1 could not get 
another no money could buy my leg. My occupation is keeping house, such 
as all country women have to do. 

Respectfully yours, 

Elbert County, Ga. Fannie Crittenden. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Georgetown, Ga., Dec. 23, 1895. 
A. A. Marks: 

Dear Sir : — I have been wearing limbs of your make for the last twenty- 
four years, and I most cheerfully state that they have given great satisfaction. 
I prefer your make of leg to any other, for noiselessness, durability, and per- 
fect fit from measurements. 

The rubber foot surpasses all others, and wears well. I have had three of 
your limbs, and have given them severe tests. I have been wearing artificial 
limbs for thirty years ; I have worn one other make, but your make is far 
ahead. I have not paid one cent for repairs. My leg is amputated six 
inches below the knee. 

Very respectfully yours, 

John Ford. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Oconee County, Ga., Dec. 22, 1895. 
A. A. Marks : 

Dear Sir ; — I beg leave to state that I have been wearing your rubber 
foot for fifteen or sixteen years, that previously I had worn three other dif- 
fent makes of artificial limbs, and that yours excels them in every particular, 
and that I shall never wear any other leg as long as I can get Marks' leg. I 
have walked twelve miles without inconvenience. 

I have examined twenty different makes of legs and feet, and as for power, 
certainly at the ankle joint, and durability, yours far surpasses them all. The 
old style ankle joint and cat-gut accompaniments will have to take a back seat. 
Ours is an age of progress ; scientific development will always lay shoddyism 
in the shade. 

Yours truly, 

A. Louts Barge. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



411 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Jasper County, Ga., Dec. 17,1895. 
I have used your artificial foot and leg continuously for eleven years, and 
it gives perfect satisfaction. The fit by measurements was perfect. I had no 
repairs done, although I was in active business, such as salesman in retail dry- 




No. 1208. 

goods and grocery store, and have walked the old field bird-hunting for 
one-half day at a time. The rubber foot seems as good to-day as when first 
bought. 

Yours truly, 

Thos. Ezell. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Richmond County, Ga,, Dec. 16, 1895. 
Dr. A. A. Marks : 

Dear Sir : — Eighteen years ago my leg was amputated below the knee. 

In conversation with a friend he advised me to order a leg from you. I took 
the measure in Augusta, Ga., sent it on to you in July, seventeen years ago. 
I put it on without anything being done to it in the way of adjustment. I have 
worn it ever since, and have not paid a cent for repairs, and have not done any- 
thing on it myself. Have been farming ever since, and being - a fleshy mail. 
working hard, you know the test I put the leg to. I know one gentleman who 



412 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



wore (or tried to wear) five different make of legs, and conld not wear any of 
them. I recommended him to send to you for one. He did so, and now he 
says he wears it with perfect ease. It was a good day for the maimed when 
you put the rubber foot into use. 

Yery respectfully, 

Geo. R. Dorsey. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Sumter County, Ga., Dec. 17, 1895. 
Mr. A. A. Marks, New York City : 

Dear Sir : — I have worn your patent, made from measurements for amputa- 
tion below knee, for ten years with great ease, and without any repairs. I 
consider the rubber foot the greatest wonder of the limb, giving as it does a 
life-like motion, and rendering the wearer capable of walking on uneven sur- 
face with ease and dispatch. 
I work on a farm, my occupation being a planter. 

Most respectf ally yours, 

Jesse J. Weaver. 



INSTEP AMPUTATION. 

Savannah, Ga., Dec. 18, 1895. 
Dr. A. A. Marks, New York : 

Dear Sir : — Fourteen years ago I was injured by a car of the. Central Rail- 
road at Savannah. 

Since that time I have been wearing one of your artificial feet for amputation 
at the instep. My occupation is very laborious, being assistant warehouseman 
for M. Maclean & Co. I can truly say that your rubber feet are very durable, 
and comfortable and convenient, and I am very much pleased with it. 

Yours respectfully, 

Jno. L. Spivey. 



ABOVE-ELBOW AMPUTATION. 

Atlanta, Ga., Dec. 21, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I have been wearing an artificial arm of another manufacturer 
with y<3ur rubber hand attached for several years, and must confess that I am 
delighted with it, especially the improved adjustable finger. For convenience 
I keep two rubber hands, one which my wife carefully takes charge of, with 
my party or opera glove on it, and the other I keep for everyday use ; all I 
have to do is to touch a spring and the hands are changed. 

Allow me to mention the fact that in all my dealings with you you have ful- 
filled your contracts to the letter. You have given satisfaction to me and 
all my friends in every instance. 

One thing I wish to mention : that is, I have more than paid for the extra 
cost of rubber hand procured from you by the saving in the wear of kid gloves. 
On the hard wooden hands and fingers a glove will not last over a month ; on 
your hands they do not wear out in six or eight months. This, together with 
the soft and natural feel, would commend them with me in preference to 
others if for no other reason. 

Your limbs and your dealings give perfect satisfaction. I have never 
regretted recommending you or them. 

Truly yours, 

J. S. Todd, M. D., 
Professor Therapeutics and Materia Medica, 
Atlanta Medical College. 



A. A. MAEKS, ARTIFICIAL LIMBS, NEW YORK CITY. 413 

ABOVE-ELBOW AMPUTATION. 

Fitted from Measurements, 

Augusta, Ga., Dec. 18, 1895. 
A. A. Marks, Esq. , New York City : 

Dear Sir : — The artificial arm with rubber hand manufactured for me by 
you gives perfect satisfaction. My arm is amputated above the elbow. You 
made perfect tit by measurement taken by my father under your direction. I 
received the arm April, 1887, and have been wearing it every day since, with- 
out the least inconvenience and without any repairs. I do not know how I 
could do without it. I can use it much better than I expected. I can hold my 
needles in knitting, and by its aid can do various kinds of fancy work. 
Very respectfully yours, 

Alice Lamkin. . 



IDAHO. 
BOTH FEET AMPUTATED AT INSTEPS. 

Fitted from Measurements. 

Oneida County, Idaho, May 10, 1894. 
Mr. A. A. Marks : 

Dear Sir :— I received from you a pair of artificial legs on the 18th of Sep- 
tember, 1893, and have been wearing them continuously. I can truthfully say 
that they are the best that I have had, for I suffer no inconvenience in wearing 
them, and the rubber feet are so elastic and natural that even my most intimate 
friends are surprised in the change it makes in my appearance. There is no 
rattling and squeaking of joints and no bolts or screws to get loose, I am more 
than satisfied with my bargain. 

Yours respectfully, 

Benjamin Edwards. 



ANKLE AMPUTATION. 

Fitted from Measurements. 

Bannock County, Idaho, Jan. 24, 1895. 
Mr. A. A. Marks: 

Dear Sir :— The fit is very good; I like the leg very well. I think the India- 
rubber foot and aluminum socket are first rate. I can go for a walk, climb 
ladders, run, with the comfortable feeling- of knowing that I am not going to 
break any straps or hinges, etc. I made a snow-shoe trip the other day of 
about six miles. I got along very well. I am, 

Yours truly, 

Alfred Heatley. 



ILLINOIS. 

BOTH LEGS AMPUTATED BELOW THE KNEES. 

Fitted from Measurements. 

Du Page County, III., Dec. 17, 1895. 
A. A. Marks : 

Dear Sir :— I have worn a pair of your artificial feet for eleven years and 
am well pleased with them. My right leg was amputated six inches, and my 
left eleven, below the knee. 

Through a friend's advice I purchased a pair of your limbs, and am not 
sorry that I did so, for I don't think they can be beat. I am now following 
operating, and very often I have occasion to deliver messages to conductors ou 



414 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



through trains. I think nothing of jumping on and off a train running twelve 
or fifteen miles per hour, and pick up anything and put it on my shouldei 
that don't weigh over one hundred and twenty -five pounds. As far as walking 
is concerned, I think that I can keep up with the most of them that have twc 
sound legs. One day last summer a party bet me five dollars that I couldn't 
walk four miles in two hours ; so I took him up. I made it just in one hour 
and twenty-five minutes, and it was on a fearfully rough road, rocks and hills, 
lots of them, and didn't even chafe the skin on my stumps. They fit so per- 
fectly from the measurements I sent, and they haven't been any expense to me 
since I got them. The rubber foot is, I think, as near to the natural foot as it 
is possible to get it. 

I can put my hands on anything that is breast high and spring up en it. 
Now, these stories look big, but I can bring proof to all of them. 

I am, yours truly, 

W. J. Harmes. 



BOTH LEGS AMPUTATED BELOW THE KNEES. 

Fitted from Measurements. 

Logan County, III., Dec. 21, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I take pleasure to inform you of the fact that your artificial 
limbs w r ith rubber feet have given me entire saisfaction. I wear them with 
comfort. 

Yours respectfully, 

Miss A. Prange. 



BOTH LEGS AMPUTATED BELOW THE KNEES. 

Fitted from Measurements. 

Moultrie County, III., Dec. 18,' 1895. 
Mr. A. A. Marks : 

Dear Sir : — The pair of artificial limbs you made me some ten years ago 
from measurements has given me entire satisfaction. I have not been out one 
cent for repairs. 

Yours truly, 

J. M. Rogers. 



KNEE-JOINT AMPUTATION. 

McLean County, III., Dec. 18, 1895. 
Mr. A. A. Marks: 

Dear Sir : — I have worn your artificial leg for about twenty-five years. I 
am a shoemaker by trade. Knee amputation. 
I think that the rubber foot is better than any other kind. It is more pliable. 
Yours respectfully, 

R. C. Chainey. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Chicago, III., Dec. 21, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I had an artificial leg made by measure, as you know. It fits 
all right and has never cost me a dollar in over three years. I am a farmer, 
and do as much work as my hired men. I never use a cane to walk with. I 
have a boy seven years old. He often wants to run me a foot-race, but I can 
beat him. 

Yours respectfully, 

Ed. Hews. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 415 

BELOW-KNEE AMPUTATION. 
Fitted from Measurements. 

La Salle County, III., Dec. 20, 1895. 
Mr. Marks : 

Dear Sir : — I have worn your make of artificial limbs eleven years, and 
like them very well. I am a farmer, and do a great deal of work. My limb 
was taken off halfway between the knee and ankle joint. 

Yours truly, 

W. Henry Jones. 



ANKLE-JOINT AMPUTATION. - 

Fitted from Measurements. 

Fulton County, III., Dec. 19, 1895. 
Mr. A. A. Marks : 

Dear Sir : — My foot was amputated when but a child of thirteen, and as 
soon as it was sufficiently healed I had one of your admirable rubber feet 
applied from measurements, and it fitted me as perfectly as though I had gone 
to New York and had the foot fitted. I have used the foot twelve years now, 
to the untold satisfaction of myself and the utmost gratification of my friends, 
who often tell me they would never notice anything peculiar about my walk. 
I have lived with people for months without their discovering that I was lame.- 
During the greater part of the time since I have worn your artificial foot I 
have attended a boarding school, with its usual number of stairs, which I have 
run up and down with the greatest ease. 

Very gratefully yours, 

Hattie L. MacGowan. 



ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Livingston County, III., July 11, 1896. 
Mr. A. A. Marks : 

Dear Sir : — My leg was amputated on January 14, 1895, and April of that 
same year I put on a leg made by you. After the first two or three weeks I 
wore the leg from the time I got up to going to bed at night. Last August, 
while away from home, I kept the leg on forty hours at a time very comfort- 
ably. Just a month ago people were very much surprised to see me without 
my leg : they asked me if it was broken ; the fact was I took my leg off to ride 
a bicycle, the leg being amputated above the knee I considered the artificial 
would be in my way in riding a wheel. People that see me every day and 
know that I have an artificial leg say they can hardly realize it. My natural 
leg before amputation being stiff, and short about an inch and a half, I assure 
you I walk better now with my Marks leg than I did before. I am, 

Truly yours, 

Robert F. Allen. 



INDIANA. 

ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Gibson County, Ind., Jan., 1896. 
Mr. A. A. Marks: 

Dear Sir : — I will have to say that the artificial leg you made me from 
measurements fits as perfectly as possible. 

If I had come to the shop and you had taken the measurements yourself, I 
doubt that results would have been better. 

I have worn it for about eight years. I put it on the next day after I got it, 



416 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



and have worn it every day since, from early in the morning till late at night. 
My occupation is circular and band saw filer ; I keep up all the saws for a large 
circular and band saw mill. I have to be on my feet most all day. I get 
around almost anywhere without a stick. As to the rubber foot, I think it is 




No. 1209. 

the finest thing out. It does not jar me when I make a misstep. I only have 
six inches of a stump, and I get around better than others I see that have worn 
other make of legs. James M. Pritchett. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Cass County, Ind., Dec. 16, 1895. 
A. A. Marks : 

Dear Sir : — I take pleasure in testifying to the satisfaction I have derived 
from the use of your artificial limb. 

I have worn it nearly ten years. I have no hesitation in saying that your 
limbs are the simplest and the most useful that are made. Others have ex- 
pressed the same opinion as myself. My limb was amputated below the knee 
January 20, 1886, and in about six months afterward I sent my measurement 
for a limb, which was made without my presence. 

Yours respectfully, 

W. Albert Thomas. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Delaware County, Ind., Jan.. 26, 1896. 
A. A. Marks, Esq.: 
Dear Sir : — I purchased an artificial leg of your manufacture, with the 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 417 



patent jointless rubber foot, about thirteen years ago, and must say that it far 
exceeds its representations. 

My leg was amputated just three incnes below the knee-pan, and I went so 
long on what is called a peg leg that my stump was shaped badly, but I go 
just the same, regardless of these drawbacks ; can skate on ice or roller skates. 

Yours truly, 

Wm. H. Roberts. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Grant County, Ind., Dec. 16, 1895. 
Dear Sir : — I write you in regard to the artificial leg you made for me nearly 
eleven years ago. I consider it superior to any other leg I have ever worn ; it 
has not been out of order since I got it. The lightness, easiness, and softness 
of the rubber foot, far excels any other leg I have ever seen. I am a broom 
maker, and our factory is one mile from town. I walk it twice a day, and 
don't tire. I have worn artificial legs for twenty-eight years. 

Yours truly, 

A. Dennis 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Whitley County, Ind., Dec. 18, 1895. 
Mr. Marks : 
Dear Sir : — You made me a leg in 1879, and I wore it up to last fall. The 

new one I like better than the first. I have worn a leg, but I did not 

walk as well as I can with yours. My leg is amputated four inches above the 
ankle. My occupation a farmer ; I weigh two hundred pounds. 

Yours respectfully, 

S. A. Flickinoer. 



BELOW-ELBOW AMPUTATION. 

Fitted from Measurements. 

Spencer County, Ind., Dec. 17, 1895. 
Gentlemen : — I received an artificial hand on the 9th of November, 1885. 
It was fitted in the city by A. A. Marks, and I have worn it ever since with 
satisfaction. I have had no repairs on it of any description. The rubber 
hand is light and durable, and can be used in holding light things. My occu- 
pation is that of a teacher. 
I would not be without the hand for any price. 

Thos. Saunders. 



ABOVE-ELBOW AMPUTATION. 

Fitted from Measurements. 

Elkhart County, Ind., Aug. 5, 1896. 
Mr. A. A. Marks : 

Dear Sir : — It is a pleasure to be able to speak of the merits of your artifi- 
cial arms with rubber hands. My left arm was amputated five inches from the 
shoulder, and I purchased from you two years ago an arm. It has been in 
constant use since. I must confess that words cannot express the satisfaction 
and benefit I have derived from it. The cost of repairs during the two years 
is too small to mention. My occupation is that of freight conductor for the L. 
S. & M. S. Ry. I am yours truly, 

A. E. Watson. 



418 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



INDIAN TERRITORY. 

ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Cherokee Nation, Ind. Ter., Jan. 3, 1896. 
Mr. A. A. Makes : 

Dear Sir : — In July, 1884, I accidentally split my right knee-joint with an 
ax, which limb three days later was amputated four inches above knee-joint, 
leaving me an eight-inch stump. 




No. 1210. 

In January, 1886, I purchased my artificial leg of you, by sending measure- 
ments taken by one of my neighbors and myself. I am now compelled to say, 
that, after about ten years of constant use, I feel confident I made no mistake 
in taking your patent. 

I often walk to church, over a mile, in company with others. My chief oc- 
cupation is farming. I often saw wood all day, or I can pick a hundred 
pounds of cotton in a day, and that is about the amount I picked before my 
leg was amputated. 

Yours truly, 

J. D. Cluck. 



BELOW-KNEE AMPUTATION. 

Fort Supply, Ind. Ter., Feb., 1896. 
A. A. Marks, N. Y. City : 

Sir: — I take pleasure in stating that the artificial leg with rubber foot which 
I received from you has given entire satisfaction. I consider it near perfec- 
tion, compared with others I have worn. I am in the employ of the United 
States Government as guide and interpreter, and am in the saddle a great por- 
tion of the time. 
I have as yet had no occcasion to have any repairs to the leg. 

Yours truly, 

Amos Chapman. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 419 



PARTIAL-FOOT AMPUTATION. 

Fitted from Measurements. 

Vinita, Ind. Ter., Jan. 1, 1896. 
Mr. A. A. Marks : 

Dear Sir : — I am glad to testify in this way that your appliance with rubber 
foot for a Chopart's amputation is one of the finest articles I have ever seen. 
My foot was cut off by a mowing machine, August 4, 1891. I commenced 
using your aluminum leg with rubber foot last April and it has given entire 
satisfaction. I am a farmer by occupation and have walked as high as nine 
miles a day. 

Respectfully yours, 

F. L. Clinkenbeard 



IOWA. 
ABOVE-KNEE AMPUTATION. 

Dallas County, Ia., Oct. 29, 1887. 
Mr. A. A. Marks : 

Dear Sir : — I have used one of your patent limbs for six years, and am well 
satisfied with it. I am a coal miner by occupation. I think that your rubber 




No. 1211. 

foot is a splendid success ; it suits me. I never tried any other, nor do I wish 
to, as long as I can get one of your make. Mine is an upper amputation ; I 
have nine inches of a stump ; I can walk almost as fast as any ordinary man. 

S. T. A. 



ABOVE-KNEE AMPUTATION. 

Jefferson County, Ia., Dec. 17, 1895. 
A. A. Marks, Esq.: 

Dear Sir : — It is now about seventeen years since I got your leg, and have 
worn it constantly since, and it appears to be perfectly sound and good vet. never 
having to be repaired, the rubber foot being firmly attached to the leg. The 
knee joint does not rattle or make any noise, and appears to be as good as when 
new, seventeen years ago. 



420 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



I own a small piece of ground in this city on which I cultivate small fruit. 
I do all the hoeing, pruning, and a good part of the picking of the fruit. 

I am a carpenter by trade, and work at the business when not engaged in my 
fruit garden. I climb up and down ladders when at work on houses. 

R. Stephenson. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Clinton County, Ia. , Dec. 19, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I have worn two different make of limbs, but neither gave me 
as good satisfaction as yours. I feel proud in recommending your limbs, as 
they are the best in the world. I am a great lover of sport, such as fishing and 
hunting, and can walk all day. My weight is two hundred pounds. I have 
worn one of Marks' limbs for over sixteen years, and it has never needed 
repairs. I had the measurements taken where I live. 

» Yours truly, 

James Carter. 



BELOW-KNEE AMPUTATION. 

Wapello County, Ia., Dec. 17, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I have worn your artificial leg for twenty-five years, and I 
regard your patent as first-class in every respect. I wore one leg fifteen years 
and it never cost me five cents. I should recommend A. A. Marks' legs above 
all others. My occupation is sewing-machine agent, and I am always on my 
feet, and the leg is never idle. I have gained from one hundred and thirty- 
five to two hundred and thirty pounds since I have been wearing the limb. 

Hundreds of people in this part of the country don't know that I wear an 
artificial limb. 

Yours with respect, 

James M. Welch. 



LEG BELOW KNEE. 

Fitted from Measurements. 

Winneshiek County, Ia., Dec. 24, 1895. 
Mr. A. A. Marks, New York City : 

Dear Sir : — I am wearing your artificial leg every day, and I get along first 
rate. I doubt that I shall ever want any but the rubber-foot leg. I have used 
others but did not like them. 

Respectfully yours, 

Joseph Budke. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Poweshiek County, Ia. , May 19, 1896. 
A. A. Marks : 

Dear Sir : — The workmanship on your leg is perfectly satisfactory, and so 
is, the fit. I have been wearing a leg with ankle and toe joints, which was con- 
tinually getting out of order, thereby causing me much annoyance. I have 
seen many kinds of legs, but for neatness, comfort, and finish yours is far ahead 
of anything that has come under my observation. 

Sincerely yours, 

John McMullan. 



A. A. MAEKS, ARTIFICIAL LIMBS, NEW YORK CITY. 421 



KANSAS. 
ABOVE-KNEE AMPUTATION. 

Saline County, Kan. , Dec. 17, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I am very glad to put my stump on to brighten the fire. After 
having worn your artificial legs with the rubber feet for more than twenty-three 
years, I have no hesitation in saying it is the best leg in use ; it is simple and the 
most durable of any of the many that I have seen. I would not use any other 




No. 1212. 



as long as I can get the rubber foot with stiff ankle ; it never drags at the toe 
from weight of mud or other matter. It is so simple a child can adjust it. 

I can heartily recommend the rubber foot as the most durable and easy to 
handle, and to any unfortunate one in need of such appliance, I would say by 
all means wear the rubber foot. I have worn artificial legs since 1862, and do 
all kinds of work. 

I am a blacksmith, and shoe horses. I have dug wells and quarried stone, 
and other heavy work. I can walk farther in a given time than any man can 
on any other kind of a leg with the same length of stump as mine ; it is only 
three inches from center of hip joint. 

Yours, etc., 

E. Lincoln. 



BELOW-KNEE AMPUTATION. 

Anderson County, Kan., Dec. 16, 1895. 
A. A. Marks, Esq. : 

A friend that was wearing one of your legs with rubber foot persuaded me 
to try your leg. Ten years ago I got you to make me one, and have worn it 
ever since, and have had no trouble with it ; I would not take a leg with ankle 
joint as a gift, unless I wanted a leg and music box combined. 

My leg is off five inches below the knee. I walk without a cane, and very 
few notice my being lame ; I think I do as much walking every day as any 
man in our little city, and my leg never gets sore and has never been out of 
repair since I got it. 

Very truly yours, 

J. A. Bell. 



422 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Montgomery County, Kan., Dec. 19, 1895. 
State of Kansas, ) 

County of Montgomery, ) 

J. C. Blair, being duly sworn upon his oath, deposes and says as follows : 

I have worn artificial limbs about nine years. 

I wore one manufactured by of Independence, Kan., about eleven 

months, which was of but little service to me. It was too heavy, did not fit, 
and was continually getting out of order at the ankle joint, and was a great 
discomfort to me. I then sent measurements to A. A. Marks of New York 
oity, and in a very short time received one of their artificial legs with rubber 
foot. I have worn it about nine years, and it has given satisfaction. 

I have no fault to find, and believe that the rubber foot is the best in the 
world, and can be surpassed by none. 

My leg is off four inches and a half below the knee. 

I am in the real estate business in Kansas ; can take care of my horses, har- 
ness and hitch them to buggy. I have walked as far as four and one-half 
miles at one time, while wearing Marks' artificial leg. 

Signed, J. C. Blair. 
Witness, Caft. Geo. A. Peck. 
State of Kansas, ) 

County of Montgomery. ) ' 

Subscribed and sworn before me, a notary public, in and for said county 



and State. 



J. C. Blair, 

Notary Public. 



BELOW-KNEE AMPUTATION. 

Russell County, Kan., Dec. 20, 1895. 
A. A. Marks : 

Sir : — It is with pleasure I recommend your artificial leg, knowing by long 
experience that there is no other limb made that can give the satisfaction your 
artificial limb gives. I have been using your make for the last twenty-four 
years, and am well pleased with it. My occupation is farming. My limb is 
off from one and one-half inches below the knee joint. It has never cost me 
ten cents for repairs since I have been wearing your make of limb, and the 
rubber foot is just what makes your limb the best. 

Hoping you success, I remain yours, 

S. B. Andrews. 



BELOW-KNEE AMPUTATION. 

Sumner County, Kan., Jan. 22, 1896. 
Mr. A. A. Marks : 
Dear Sir : — I have worn one of your artificial legs for nine years. 
I received one March 9, 1886 ; put it on the next day, but could not make 
much headway with it ; but I kept trying and soon conquered it. I am a 
farmer and am on my feet all the time. It is entirely satisfactory. 

Yours truly, 

O. H. Benedict. 



BELOW-KNEE AMPUTATION. 

Topeka, Kan., Dec. 17, 1895. 
I have worn one of your legs for a number of years. I find it durable and 
comfortable ; have plowed, harrowed, and worked in the harvest. I am sixty, 
two years of age. I consider yours the best leg in the world. 

Elias B. Helm. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 423 

ANKLE-JOINT AMPUTATION. 

Fitted from Measurements. 

Topeka, Kan., Dec. 16, 1895. 
A. A. Marks, Esq. : 

Dear Sir : — I have worn an artificial foot since 1879. The point of amputa- 
tion is at the ankle, with a portion of the heel remaining. It is a modification 
of Symes' operation. 

I liad great difficulty in getting an appliance, and I found it a point very 
difficult to supply with a comfortable and useful foot. I made many unsuc- 
cessful trials and about despaired ever being able to walk without the aid of a 
crutch. A friend advised me to apply to you, as he had some knowledge of 
the rubber hands and feet. I did so and received directions from you how to 
take measurements for the appliance. I sent on the measurements and soon 
received by express the limb and rubber foot. It was a perfect fit and was 
comfortable. I could walk with ease and with scarcely a perceptible limp. 

I have worn this appliance since September, 1882, and without repairing it. 

1 am more than pleased with it, and know from experience that you are the 
only manufacturer of a comfortable and useful limb for the amputations known 
as Symes' or Chopart's. I am a physician, and see quite a number of people 
wearing artificial limbs, and am well satisfied that the limbs manufactured 
with the rubber hands and feet are far superior to any other. 

Yours sincerely, 

S. G. Stewart, M. D. 



ABOVE-ELBOW AMPUTATION. 

Fitted from Measurements. 

Kansas City, Kan., Jan. 22, 1896. 
Mr. A. A. Marks : 

Dear Sir : — I have a left stump five and one-half inches in length, on which 
I wear one of your arms with rubber hand ; the same was fitted from measure- 
ments. I have worn it every day since 1881, and treble the amount of cost 
would not induce me to be without it. Repairs have been comparatively 
nothing. A new strap occasionally, that is all ; and, further, I know the 
rubber hand is far superior to any other I have ever seen in use. My hand 
is as good as the day I received it. I am a newspaper man by occupation. 
My arm keeps me balanced nicely, and fills the vacancy so perfectly that many 
people associating with me do not know that I am a one-armed man. 

R. A. Kope. 



KENTUCKY. 

ABOVE-KNEE AMPUTATION. 

Greenup County, Ky., Dec. 17, 1895. 
A. A. Marks : 

Dear Sir : — I have worn an artificial leg made by you for twenty years. 
Having worn other makes of legs, I consider yours far superior for comfort to 
any other leg made, and the rubber foot is far ahead of any I have ever seen. 
My present occupation is a farmer, and I do all kinds of farm work. My leg 
is amputated about five inches above the knee. 

Yours respectfully, 

Harrison Riqgs. 



4&4 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Concord, Lewis County, Ky., Dec. 24, 1895. 
Mr. A. A. Marks : 

Dear Sib : — Having worn one of your artificial limbs for eight years, I can 
inform you that I am more than pleased with it. 

I am a farmer and can do almost any kind of work. I would not do without 
one of your legs for twice the value of it. The rubber foot is so natural ; there 
is no rattling noise, and the step so soft and light. I recommend it to all in 
need of one as being the best. 

Yours truly, 

John Vance. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

McCbacken County, Ky., Dec. 17, 1895. 
Mb. A. A. Mabks : 

Kind Sib : — I sent my measurements to you for an artificial leg about eleven 
years ago ; it came in about two weeks after I ordered it. The fit was perfect. 
It has not cost a cent for repairs. I am more than pleased with the rubber 
foot, which works with perfect ease. I have worn artificial limbs for fifteen 
years, but have found none to suit me half so well as the one I have now. 

Very respectfully, 

Dick Rudy. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Boone County, Ky., July 7, 1896. 
Mb. A. A. Mabks -. 

Deab Sib : — I have been wearing one of your artificial legs going on six 
years, and it gives perfect satisfaction. I have seen several using other makes 
and I can walk away from them with ease. I do all kinds of farm work, and 
I make it a point to lead. The field and other hands follow, and when I buy 
another leg it will be of your make. 

Truly yours, 

G. E. LlLLIA. 



KNEE-BEARING AMPUTATION. 

Fitted from Measurements. 

Logan County, Ky., Jan. 29, 1895. 
Mb. A. A. Mabks : 

My Kind Sib : — I have been for a long time desirous of writing and express- 
ing my continued satisfaction with the artificial leg you made for me. It has 
been nearly five years since I obtained my artificial leg from you. I can walk 
very well without a cane or other support, and without your patent rubber foot 
my life would be miserable. 

Respectfully yours, 

Wyett T. Cbafton. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 425 



LOUISIANA. 

BELOW-KNEE AMPUTATION. 

New Orleans, La., Dec. 31, 1895. 
Mr. A. A. Marks : 

Dear Sir : — After examining four different patents, I concluded that A. A. 
Marks' patent artificial leg was the one that came up to my wishes : and I can 
add that it has far exceeded my expectations. I have met acquaintances on the 
street who, not having heard of my accident, were astonished when I told them 
I was using an artificial leg. 

I remain, with respect, 

Mrs. S. Easton. 



MAINE. 

ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Portland, Me., Jan. 9, 1896. 
Mr. A. A. Marks : 

Dear Sir : — I have worn one of your artificial limbs nearly twelve years. 
I think the rubber foot is a good thing, as it is perfectly noiseless. 
I can vouch for your success in fitting from measurements. 
My occupation is that of a carpenter, some parts of which have been very 
trying to an artificial limb. 
Point of amputation, halfway between the knee and thigh. 
Yours very truly, 

Herbert W. Fickett. 



ABOVE-KNEE AMPUTATION. 

Penobscot County, Me., Dec. 16, 1895. 
Mr. Marks : 

Dear Sir : — Your first artificial leg I wore for years. Your last one I got in 
January, 1886, and have worn it with perfect ease every day. 

My weight is 180 pounds. My business is farming, driving teams, which is 
all laborious work. I am very sorry to say that once in awhile I visit the ball- 
room, and the ladies all wonder how I can get around so nicely on an artificial 
limb. 

Yours respectfully, 

A. O. Wing. 



ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Waldo County, Me., Dec. 17, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I can say of the merits of your leg that it is the best the Gov- 
ernment provides for its soldiers. My first leg was made by Dr. . The 

leg was a source of trouble to me. I was most of the time with a broken leg, 
and had to wear a peg leg of my own make. 

I have worn an artificial leg for 31 years. Eleven years ago when I applied 
to you for a leg, you sent me blanks for measuring ; I took my own measure- 
ments and sent them to you. 

As soon as I received the leg I put it on, and have worn it ever since ; that 
was twelve years and a half ago ; it fits me the best of any leg that I have ever 
had. I am a farmer and have some hard work. 

Yours truly, 

Wm. J. Brown. 



426 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

BELOW-KNEE AMPUTATION. 

Kennebec County, Me. , Jan. 1, 1896. 
Mr. Marks : 

Dear Sir : — I am well pleased with your make. My leg is off five inches 
below the knee, and I have worn it for nine years. I expect to have another 
of your make very soon. 

Respectfully yours, 

Francis Slaiger. 



BELOW-KNEE AMPUTATION. 

Dec. 17, 1895. 
Mr. A. A. Marks : 

Dear Sir : — The artificial leg you made for me gives good satisfaction, and 
I don't think there is any other foot made as good as the rubber foot. I have 
my leg going on eleven years, have had no repairs done to amount to anything. 
I am a miner, and the work is very hard, but my leg has stood the work well, 
and I can't see but that it is as good now as ever. 

Yours, etc., 
Kennebec County, Me. * Eugene Fitch. 



BELOW-KNEE AMPUTATION. 

Lincoln County, Me., Dec. 17, 1895. 
A. A. Marks : 

Dear Sir : — I have worn your rubber foot ten years, and like it so well I 
would wear no other. My business is that of a stone-cutter, and I am obliged 
to stand all day. I am very hard on an artificial leg, yet this one has cost me 
nothing for repairs, and I walk very comfortably with it. My leg is amputated 
three inches above the ankle joint. 

Truly yours, 

E. Y. Bryant. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Dec. 16, 1895. 
A. A. Marks : 

Dear Sir : — I can say for one that your leg is the best leg that is made. I 
have worn the ankle joint leg. Every little while I had to put in new cords. 
The noise it made was unbearable. But it isn't so with your rubber foot, 
which is firm and solid. 

I am a laborer, and I work on my leg every day. I have worn artificial legs 
for thirty-two years. I am, 

Yours respectfully, 

W. H. Thomas. 
Waldo County, Me. 



BELOW-KNEE AMPUTATION. 

Washington County, Me., Dec. 18, 1895. 
Mr. Marks : 

Dear Sir : — The leg you made for me over ten years ago is almost as good 
as the day I got it. It is the best leg that I ever wore. 

I have been wearing artificial limbs since 1864, and have had many different 
makes, but I must say your make is the best. 

Your legs do not get out of repair as the others do. It'used to cost me a 
great deal to keep the other different makes in repair. Since I have worn 
your new patent leg I have not been laid up with chafing one day. Of 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 427 



the other makes I never had but one that would not chafe my stump and lay 
me up. 
I like your rubber foot very much and would have no other make. 
I have the best fit from you that I ever had. I am a sealer by trade. I work 
in "a sardine factory, and I can make my rubber foot get around with the best 
of them. 

Yours, 

Hugh Thompson. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

York County, Me. 
Mr. Marks : 

Having worn one of your artificial legs for twenty years, I can truly say 
they are the best that I have ever seen. 

The rubber foot is a marvel of neatness and durability, and I could not wear 
any other. I wear it with ease and comfort, and have paid but a very small 
sum for repairs. I do all my housework and go in and out of doors without 
canes. 

Yours very respectfully, 

Mrs. S. E. Silley. 



PARTIAL FOOT AMPUTATION. 

Portland, Me., Dec. 16, 1895. 
Mr. Marks : 

Dear Sir -.—Your aluminum leg combined with the rubber foot is the 
neatest and best I have ever used. I have used two different rubber feet with 
wood artificial legs, but I would rather have one aluminum leg than six wood 
artificial legs for ease and lightness. My occupation is shoemaking, which 
requires good feet, because I have to stand all day at one part, and I have to 
run large rollers with treadles, both steam and foot power. 

Yours respectfully, 

John Edward Frates. 



MARYLAND. 



RIGHT LEG AMPUTATED IN THE KNEE, AND LEFT BELOW 

THE KNEE. 

Fitted from Measurements. 

Baltimore, Md., April 1, 1896. 
Mr. A. A. Marks : 

Dear Sir : — I run the electric plant for the Luray Caves and get along so 
well on my limbs that I forget at times that they are any other than my natural 
limbs. I can work at my trade and am able to do my own firing and take 
charge of the whole electrical plant, which is no small one. I have forty-six arc 
lights and over three hundred incandescent lamps. I have to climb and carry 
a ladder through the caves every day to trim my arc lamps, and my boss 
says I am as much a curiosity as the Caves. I am at Luray from April 10 
until December 1, and would be pleased to have anyone call on me in 
reference to your limbs, for they are undoubtedly the best in the world. I 
run as engineer on a boat in a friend's place who was sick this winter, and the 
captain did not know that I wore two artificial limbs until I told him when I 
left. I was there three months. 

Address all mail to Luray, Page Co., Va. 

Respectfully yours, 

Engineer of Power House. Harry E. Hohn. 



428 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



BOTH LEGS AMPUTATED BELOW THE KNEES. 

Baltimore & Ohio Railroad Company, 
Sup't of Motive Power Office, Dec. 16, 1895. 
My Dear Sir : — I am just in receipt of your favor on the 14th inst. In 
reply would say that your work has been entirely satisfactory to me, and that 
I never lose an opportunity to recommend your goods. You are at liberty to 
use this letter in your revised book of Treatise on artificials, and it will give 
pleasure to answer inquiries in connection therewith. 
Thanking you for past kindness, I am, 

Yours truly, 

Henry M. Etchison, Baltimore, Md. 



BOTH LEGS AMPUTATED BELOW THE KNEES. 

Baltimore, Md., Dec. 16, 1895. 
A. A. Marks : 

Sir : — You will excuse me for writing to you, but it cannot be prevented, 
because the young man and I for whom you made the legs are so much 
pleased that we cannot recommend any other make. Just think, I am a sick 
man, but I can walk nearly every day five miles with ease. I have worn your 
patents for over six years, and with a little care will wear them as much 
longer. Respectfully, 

Chas. Kridenoff. 



ABOVE KNEE AMPUTATION. 

Allegany County, Md., Dec. 18, 1895. 
Mr. A. A. Marks : 

Dear Sib :— Having lost one of my legs on the railroad some years ago, I 
applied to you for assistance, and received one of the most valuable limbs 
made. I consider Mr. Marks' limbs without a rival. 

Yours truly, 

John Henry Paul. 



ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Garrett County, Md., Feb. 5, 1896. 
Mr. A. A. Marks : 

Dear Sir : — In 1883 1 purchased one of your limbs, and I commenced wearing 
it shortly after getting it, and have worn it every day since. I was very 
prejudiced against the stiff ankle at first, but after a little patience I got along 
better than I ever expected to. The leg has far exceeded my expectations. 

It has proved to be just what Mr. Marks said was the beauty of the limb : it 
does away with a lot of machinery that I have seen in other artificial limbs. 
It is not accompanied with rattling or an unpleasant uoise when walking ; 
there are no springs, hinges, or bolts to get out of order. My leg has not cost 
me but twenty-five cents for repairs in four years. I have given it some hard 
trials ; I have done a great deal of walking ; people have been surprised when 
I told them I wore an artificial limb. 

Yours truly, 

P. Cline. 



ABOVE KNEE AMPUTATION. 

Fitted from Measurements. 

Baltimore, Md., Dec. 17, 1895. 
A. A. Marks : 

Dear Sir :— I had my leg amputated above the knee twenty-nine years ago, 
and directly after I got one of your limbs, which lasted me fifteen years with 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 429 



very little expense. I have only had two of your limbs in twenty-eight years, 
and it cost me but a trifle in that time for repairs. As to the rubber foot, it 
cannot be excelled. I would have no other, and never will have any other. 
I must say that as to measurements and fittings I have never had any trouble. 
Both my legs were fitted from measurements. My occupation for the last 
twenty years has been the grocery business. This business is laborious for 
one who undertakes to load and unload wagons, as I am frequently called 
upon to do. In fact, I might say that I do everything that is required of me, 
the same as others with natural limbs. 

It is no task for me to climb ladders, which I had to do when I had men 
building for me. 

Yours respectfully, 

Jeremiah Keady. 



ABOVE-KNEE AMPUTATION. 

Baltimore, Md., Dec. 23, 1895. 
A. A. Marks, New York City : 

Dear Sir : — I have been wearing an artificial leg since December 10, 1880. 
It is an excellent fit, and well shaped ; it seems to be as strong as the day I 
received it. 

I have been engaged at manual labor most of the time (repairing furniture 
and upholstering). My amputation is above the knee, with about six inches 
of stump. 

I am respectfully yours, 

P. J. Cole. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Dec. 18, 1895. 
I am by occupation an accountant, and put to pretty hard tasks, such as 
standing half the time and walking a distance of three miles twice a day. I 
have worn Marks' artificial leg for nine years. 

I remain yours truly, 
Baltimore, Md. Wiley S. Devore. 



BELOW-KNEE AMPUTATION. 

Baltimore, Md., Dec. 16, 1895. 
Mr. A. A. Marks : 

Dear Sir : — The artificial leg that you made for me has given me so much 
satisfaction that I would not part with it for any consideration. It has been 
praised so highly that I get tired of listening to people commenting on it. I 
have danced on it without any inconvenience. It took me but a short time to 
break it in and caused me but little trouble. I was only too glad to dispense 
with my crutches. 

I am, dear sir, yours, etc., 

Capt. W. E. Hartlove. 



BELOW-KNEE AMPUTATION. 

Dec. 26, 1895. 
A. A. Marks, Esq., New York City : 

Dear Sir : — I have been wearing one of your legs for nearly ten years with 
perfect satisfaction. For the last nine years I walk to and from work (three 
miles each way), and often as far at night, without feeling tired. 

Yours ever, 
Baltimore, Md. R. E. Ward. 



430 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Dec. 23, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I am still wearing the leg you made me about seventeen years 
ago. I wear it every day and work at my trade — shoemaking. I think your 
patent leg is the most durable that is made. My weight is 224 pounds, and 1 
have carried three bushels of wheat on the leg. I think I know the difference 
between artificial legs, for I have worn several kinds. 

Yours truly, 

Cyrus Ridenour. 
Washington County, Maryland. 



BELOW-ELBOW AMPUTATION. 

Dorchester County, Md., Dec. 18, 1895. 
A. A. Marks : 

Dear Sir : — In the year 1881 I lost my arm. I have about half of the fore- 
arm left, and with the use of one of your artificial arms' I astonish all. My 
occupation is steam-fitting, and I can do anything that is done in saw mills, — 
file, saw, fire, engineer, and anything you could mention. 

I have been using the arm for eleven years constantly, I don't know of any 
better and don't want to. Mine cost $50. I would not be without it for 
twenty times fifty. 

I cannot tell anyone how much advantage it is to me. People wonder how 
I file circular saws and do so many other things. Take away my arm and 
hook and I feel as much at a loss as when I first lost my hand. 

J. F. Wheatley. 



MASSACHUSETTS. 

ABOVE-KNEE AMPUTATION. 

Boston, Mass., Dec. 31, 1895. 
Mr. A. A. Marks : 

Dear Sir :— In April, 1886, I was injured at Somerville, Mass., by a runa- 
way horse, so that amputation was necessary five inches above the knee, and 
in November, 1886, began to wear your artificial leg, and have not missed a 
day in wearing it since the first day I had it. I am a carpenter by trade, and 
in May, 1887, just twelve months after being hurt, began to work at the bench 
and have worked there ever since. I walk to my work, and stand all day, and 
am not any more tired at night than if I had both my legs. Without it I could 
do nothing, but with it can get along almost as well as before I lost my leg. 

Yours very truly, 

Charles C. Moulton. 



ABOVE-KNEE AMPUTATION. 

Norfolk County, Mass., Jan. 6, 1896. 
A. A. Marks : 

Dear Sir : — I am a hard-working farmer, and have worn your artificial 
limb for over twenty-five years, and still prefer it to any other make. I tried 
several kinds, but never found one that could compare with yours either in 
durability or comfort. 

Very truly, 

Charles A. Sargent. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 431 



ABOVE-KNEE AMPUTATION. 

Plymouth County, Mass., Dec. 18, 1895. 
Dear Sir :— I have used one of your artificial legs with the rubber foot, 
for amputation above the knee, for the last nine years, and it has proved 
satisfactory. Very respectfully, 

John Washburn. 



ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Suffolk County, Mass., Nov. 8, 1895. 
A. A. Marks, Esq. : 

Dear Sir : — I have been wearing one of your artificial limbs for nineteen 
years, and I feel as though I ought to thank you for your great invention. I 
had my leg amputated just above the knee, and thought I should be useless 
the rest of my life, but if you could see me go about my house and do the 
work for a family of five you would be astonished. 

Yours, very respectfully, 

Mrs. I. Kierstead. 



ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Somerville, Mass., Dec. 16, 1895. 
A. A. Marks : 

Dear Sir : — My daughter, fifteen years old, has been wearing the artificial 
leg furnished by you about eight years, and I am pleased to say that it has 
given entire satisfaction. 

Although the amputation was above the knee, and the little patient had not 
used the limb for more than three years previous to its amputation, she was 
able (greatly to our astonishment) to walk across the room without a cane 
within an hour after the application of the artificial. I consider the rubber 
foot the best substitute for the natural one that can be provided. 
Yours very truly, 

George C. Beckwith. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Dec. 17, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I have worn one of your artificial legs for the last eleven years, 
and my work is of such a nature that it necessitates my standing or walking 
nearly all day. I would say that it has not cost me a cent for repairs since I 
purchased it, and it is likely to last a number of years yet. 

Daniel Murphy. 
Berkshire County, Mass. 



BELOW-KNEE AMPUTATION. 

Berkshire County, Mass., Dec. 16, 1805. 
Mr. A. A. Marks : 

Dear Sir : — I have worn an artificial limb for thirty years. The first five 
years I wore one with a wooden foot and ankle joint. 
I have worn yours twenty-five years. 

When I laid aside the one with the wooden foot and put on one of yours I 
felt that I was nearly a sound man again. 

Yours truly, 

J H. Adams. 



432 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



BELOW-KNEE AMPUTATION. 

Dec. 16, 1895. 
Mr. A. A. Marks: 

Dear Sir : — I have used two artificial legs with ankle joints and have had 
no comfort with thern. But since I got your rubber foot, October, 1886, I am 
able to run and walk. I weigh 235 pounds, and I have had a great deal of 
walking to do. 

Yours with respect, 

Robert Kennealy. 
Boston, Mass. 



BELOW-KNEE AMPUTATION. 

Hampden County, Mass. 
A. A. Marks : 

Dear Sir : — I have mailed you to-day a photograph of myself on a wheel. 
I have worn a Marks leg for a great many years, and can do most anything 




No. 1213. 

with it. I ride from fifteen to twenty miles almost every day on the wheel, and 
have ridden forty. I have walked thirteen miles without hardly a stop. Have 
used a leg with an ankle joint, but find the Marks leg the best. 

Yours very truly, 

Frank H. Smith. 



BELOW-KNEE AMPUTATION. 

Dec. 16, 1895. 
Mr. A. A. Marks : 

Dear Sir :— I am happy to state that I still wear the leg you made for me in 
1880, and it is in good order yet. I am using it every day. 

I have only paid seven dollars in repairs, so far, in all. I have worn legs 
made by other manufacturers, with wooden feet, and ankle joints, but in all 
my years of experience I never found myself satisfied until I procured one of 
your artificial legs with the rubber foot. I walk more naturally and more com- 
fortably than I ever did on the other legs that I have worn. My work is very 
laborious, as I have to stand on my feet sixteen hours a day, lifting barrels, 
and climbing up and down stairs constantly everyday. I have worn artificial 
legs now fifteen years. I have walked a mile inside of ten minutes. 
Respectfully yours, 

Joseph H. Sylvester. 

Boston, Mass. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



433 



BELOW-KNEE AMPUTATION. 

Rockingham County, Mass., Mar. 3, 1895. 
Mr. A. A. Marks : 

Dear Sir : — It gives great pleasure to assure you that the apparatus made 
by you in 1876 has answered my expectations, enabling me to walk in a 
natural manner and leave the crutch. 

My parish work calls for a great deal of walking, which I can do with 
great ease. Hoping many others may find, as I have, the value of your great 
work, I remain. Respectfully, 

Rev. Rufus P. Gardner, 
Pastor of First Congregational Church. 



BELOW-KNEE AMPUTATION. 

Everett, Mass., Dec. 26, 1895. 
Alvah Young, employed by The Edison General Electric Co., New 
England Division, 38 Pearl Street, Boston, Mass., as a lineman, is a living ex- 
ample of the remarkable degree to which rubber feet restore lost members. He 




No. 1214. 

lost one of his legs some years ago in a railroad accident. He had a Marks 
rubber foot and artificial leg applied, and since then has engaged in active 
manual labor, earning his livelihood. He will climb a pole as dexterously as 
any of his associates, hold himself on the cross-bar with his artificial, and 
place the wires in a thoroughly workmanlike way. 



BELOW-KNEE AMPUTATION. 



Franklin County, Mass., March 25, 1896. 
Dear Sir :— Immediately after getting your leg, April, 1884, I went to 
work in a cheese factory, and worked seven months, and never lost one day. 
and ever since then my occupation has been cheese-making. From the first 
the leg has never given me any trouble. I walk with safety and comfort. I 
walk very much, and labor constantly. I have seen other kinds, but I prefer 
yours to any other. 

Yours respectfully, 

Myron D. Searles. 



434 A. A. MARKS, AETIFICIAL LIMBS, NEW TOEK CITY. 



BELOW-KNEE AMPUTATION. 

Dec. 31, 1895. 
Mr. A. A. Marks : 

Dear Sir : — After five years' experience with three artificial legs with ankle 
joints from well-known makers, and twenty-five years' constant use of the 
rubber foot, I can honestly recommend the rubber foot as the best, being simple 
in construction, firm, natural and easy in motion. 

J. W. Farnsworth. 
Middlesex County, Mass. 



BELOW-KNEE AMPUTATION. 

Dec. 18, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I have worn the artificial leg you made for me for over eighteen 
years, during which time I have worn no other. 

I am now thirty years old. I went to school until I was eighteen. Run- 
ning, playing ball, skating, and dancing were the sports I frequently indulged 
in. Your rubber-foot leg enabled me to do this and keep everyone in ignor- 
ance as to my condition. 

I have been working in a shoe shop in Brockton for twelve years and stand 
on my leg ten hours a day. 

Yours truly, 

Victor P. Beauregard. 
Plymouth County, Mass. 



BELOW-KNEE AMPUTATION. \ 

Berkshire County, Mass., Dec. 24, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I have worn one of your legs for sixteen years and it has given 
me perfect satisfaction. The rubber foot gives more of a natural step — elastic. 
I can walk farther and easier than with any other kind. I can go on the floor 
and dance with the best of them with good limbs. 

Yours, 

W. M. Field. 



BELOW-KNEE AMPUTATION. 

Worcester County, Mass., Dec. 17, 1895. 
Mr. Marks : 

I can walk one mile or two with ease on the leg you made me 1886. It is all 
right, and I am well pleased with it. 
It is off below the knee. 

Emulus Harwood. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Worcester County, Mass., April 5, 1896. 
A. A. Marks : 

Dear Sir :— My foot was amputated at the ankle joint, about seventeen 
years ago, I received a rubber foot from you, fitted by measurements. It fits 
perfectly. I work in the woolen mill. I am perfectly satisfied. 

Yours truly, 

Alexander Allen. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 435 

BELOW-KNEE AMPUTATION. 

Fitted from Measurements/ 

Worcester, Mass., Dec. 16, 1895. 
A. A. Marks, 701 Broadway, K Y.: 

Dear Sir : — Having now worn the artificial leg procured from you, I can 
say that after an experience of over twenty years with different makes yours 
with the rubber foot is the most comfortable I have ever worn, and as it was 
fitted from measures, and without any alteration whatever, I thought it phe- 
nomenal. I have not expended a cent for repairs, and it is as good as the first 
day I put it on. I am on my feet most of the time in the iron business. 

Yours respectfully, 

James P. Crosby. 



BELOW-KNEE AMPUTATION. 

Dec. 17, 1895. 
Mr. Marks : 

Dear Sir :— My leg is a great deal better than I ever expected. I can do 
very nearly as well with it as I could with my own leg. 

Yours respectfully, 
Worcester County, Mass. Willis A. Taft. 



ANKLE-JOINT AMPUTATION. 

Fitted from Measurements. 

Middlesex County, Mass., Dec. 25, 1895. 
Mr. Marks : 

Dear Sir : — I have worn one of your artificial limbs for eleven years. I 
think your rubber foot the best thing in the market, and far more durable than 
the old style. Yours respectfully, 

O. F. Stone. 



ANKLE-JOINT AMPUTATION. 

Fitted from Measurements. 

Norfolk County, Mass., Dec. 18, 1895. 
A. A. Marks : 

Dear Sir : — I have worn an artificial limb for twenty years. I have worn 
one of another kind that had the ankle joint ; it was worn out in three years ; 
and I purchased one from you. 

I wore it seven years ; it cost me $1.50 for repairs. Ten years ago I pur- 
chased another limb from you. I think it is the best limb that is made. I 
would not be without one. I am a wool sorter and have to lift and truck bales 
that weigh from one hundred to one thousand pounds. My limb is amputated 
at the ankle joint. 

Respectfully yours, 

John W. Smith. 



INSTEP AMPUTATION. 

Franklin County, Mass., March, 1896. 
Mr. A. A. Marks : 

Dear Sir :— I desire to inform you that the artificial leg you made for me in 
1886 has given me entire satisfaction. 
You have my regards for the service you have done me. 

Respectfully yours, 

Joseph Perinet. 



436 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



APPARATUS.— NO. 808 FOOT. 

Bristol County, Mass., Dec. 30, 1895. 
A. A. Marks : 

Dear Sir : — I have worn the foot steadily for over eight years and don't 
think it can be improved. I feel very grateful that you and your workmen 
have been gifted with the spirit of wisdom to know what would suit me so 
well. I am, yours respectfully, 

Belle T. Gray. 



ABOVE-ELBOW AMPUTATION. 

Fitted from Measurements. 

Barnstable County, Mass., Dec. 21, 1895. 
Mr. A. A. Marks : 

Dear Sir : — The artificial arm purchased of you eleven years ago has given 
good satisfaction. I am a farmer by occupation, and the arm has been in hard 
and constant use with very few repairs except straps and webbing. The stump 
of my arm is but six inches long, but the arm fits well, and is all one could 
expect of an artificial limb, and I can heartily recommend them. 

Yours truly, 

Chas. L. Dewey. 



BELOW-ELBOW AMPUTATION. 

Roxbury, Mass., Dec. 16, 1895. 
A. A. Marks, Esq.: 

Dear Sir : — I have been wearing one of your rubber hands for about ten 
years. It has been of such assistance and use to me that I would not be with- 
out it for a day. I am able to help myself at table and in many other ways. 

Yours truly, 

Joseph T. Mooney, 



NO. 784 EXTENSION. 

Groton, Mass., Dec. 17, 1895. 
A. A. Marks : 

Dear Sir : — I am very much pleased with the aluminum artificial leg made 
by you. I find it satisfactory in every respect, being strong, light, and neat. 
I strongly recommend it to all who are in need of such an apparatus. 

Very truly yours, 

Edwin H. Clark. 



MICHIGAN. 

ABOVE-KNEE AMPUTATION. 

Genesee County, Mich., Dec. 19, 
Mr. A. A. Marks, New York City : 

With pleasure I indorse the rubber foot as the best artificial foot manufac- 
tured. In my opinion it has no equal for durability and stillness, and for my 
use is far ahead of any ankle joint limb I ever saw ; and I have seen a good 
many different men's make and worn one about two years which cost me $50 
for repairs. The limb I am wearing now was made by A. A. Marks and I 
have been wearing his leg for over twenty years. 

Yours truly, 

Wm. H. Meaker. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITT. 437 

ABOVE-KNEE AMPUTATION. 

Clinton County, Mich. , Dec. 16, 1895. 
Dr. Marks : 

Dear Sir : — I thought I would write you a few lines in regard to the arti- 
ficial limb you made for me. I can say it is a perfect limb, both in ease of 
walking and fit. I can walk so much better than I could with the loose ankle 
flopping foot that I used to wear. After wearing a limb since 1864 I am able 
to judge, and am prepared to state that your limb is better than any other make. 

Very respectfully, 

John N. Gilbert. 



KNEE-BEARING AMPUTATION. 

Branch County, Mich., Dec. 22, 1895. 
A. A. Marks, Esq., New York : 

I have worn artificial legs for thirty years ; have during that time worn out 
two, and have had the third one now eleven years, this last one being of your 
make. I regard the one I am wearing now as being far superior in many ways 
to the other two. I wear what is termed a knee-bearing leg. 

Your make of leg gives me a better gait in walking than the others. 

I would state that I regard the rubber foot as being one of the greatest 
improvements in artificial limbs. I am a country merchant and actively 
engaged in the details of my business. Charles Carroll. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Bay City, Mich. , Dec. 19, 1895. 
A. A. Marks : 

Dear Sir : — I take pleasure in assuring you that the artificial leg you made 
for me from measurements, now seventeen years in use, is in every way satisfac- 
tory to me. It is far superior to any I have ever seen. I work in a saw-mill, 
I wear it from morning till night, week in and out. 

Yours respectfully, 

John Stewart. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Chippewa County, Mich., Dec. 17, 1895. 
Mr. A. A. Marks, New York City : 

Dear Sir : — As soon as you sent me the blanks I had my leg measured and 
ordered an artificial one. I can assure you that I am more than pleased with 
it. My leg is cut off about six inches above the ankle. I am an engineer on 
a steamboat by occupation, but I am now foreman of public works, where 
I have to be constantly on my feet, and I am sure had I not your rubber foot 
I could not have stood the fatigue. I can lift, jump, run, and walk as fast as 
most any ordinary man. I am fifty-eight years old. 

Yours, 

J. R. Cook. 



BELOW-KNEE AMPUTATION. 
Fitted from Measurements. 



Dec. 19, 1895. 



A. A. Marks : 

Dear Sir : — My limb was taken off below the knee. I took my own 
measurements and sent for your patent limb ; got it all satisfactory in 



438 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



February, 1869, and have worn it ever since. I never had any repairs on it 
only what I could do myself. 

My work is all kinds of farm work. If I thought I could not get another 
limb, money could not buy this old one. 

Yours with respect, 

Gratiot County, Mich. L. H. Norris. 



BELOW-KNEE AMPUTATION.' 

Fitted from Measurements. 

Ionia County, Mich., Dec. 17, 1895. 
Mr. A. A. Marks : 
The leg I got from you I am well pleased with. 

It was a first-class fit. I have worn it two years and a half, and it is in good 
condition yet. I can recommend that your limb with the rubber foot is much 
easier than a wooden one. Yours truly, 

Hiram Gibson. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Kent County, Mich., Dec. 7, 1895. . 
Mr. Marks : 

Dear Sir :— I have been wearing your patent artificial leg nearly three 
years, with the utmost satisfaction. My occupation is farming. I have been 
to no expense since purchasing it. Yours truly, 

James E. Johnson. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Oakland County, Mich., Jan. 10, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I am very well pleased with my leg, as I have had it about 
fifteen years or more, and it has given perfect satisfaction in every respect. 
I am a farmer, and can do all the work required of a man on a farm. 

Yours with respect, 

Adam Hemstead. 



BELOW-KNEE AMPUTATION. 

Oakland County, Mich., Dec. 20, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I have been wearing your artificial leg for nearly twenty-five 
years. I have no occasion to find fault with it. The rubber foot in my judg- 
ment is the best in the market. I especially recommend it for its simplicity 
and durability, compared with the old style. I have worked at my old busi- 
ness, as a farmer, ever since I got your leg. 

Yours very respectfully, 

Charles Hibner. 



ANKLE-JOINT AMPUTATION. 

Gogebic County, Mich., Dec. 16, 1895. 
Dear Sir : — Your aluminum leg is good and strong and light. My occupa- 
tion now is an engineer, and I can get around as good as ever. I do not use 
a cane and can highly recommend your leg to anyone who is in need of one. 
In fact, you could not tell I had one. Yours, 

John Downey. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 439 

ABOVE-ELBOW AMPUTATION. 

Fitted from Measurements. 

Kent County, Mich., Dec. 26, 1895. 
A. A. Marks : 

Dear Sir : — The artificial arm I bought of you ten years ago is in every 
way satisfactory. The rubber hand is of special benefit. I would not have 
any other kind of hand. I have only five inches of stump ; was fitted by 
measurements sent by mail ; don't think it possible to have a better fit. 

Very respectfully, 

C. S. Parks. 



MINNESOTA. 

BOTH LEGS AMPUTATED BELOW THE KNEES. 

Scott County, Minn., Oct. 13, 1895. 
My Dear Sir : — My limbs you made for me are giving the best of satisfac- 
tion ; they are more than you claimed. I can walk up or down hill without 
a cane, in fact I don't use a cane at all. 

Yours respectfully, 

J. B. FlTZSIMMONS. 

To A. A. Marks. 



BELOW-KNEE, AMPUTATION. 

Fitted from Measurements. 

Washington County, Minn., Dec. 28, 1895. 
A. A. Marks, Esq. : 

Dear Sir : — I have worn an artificial leg made by you for nearly ten years. 
My leg is amputated about six inches below the knee. 

I am very well pleased with it. My occupation being farming, I can do 
very nearly as much work as before losing my leg. 

Yours truly, 

S. J. Orr. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Wabasha County, Minn., July 16, 1894. 
A. A. Marks : 

Dear Sir : — I have had two other legs and never had such comfort with 
either as with your manufacture. I am, 

Respectfully yours, 

Gertrude E. Flynn. 



ABOVE-ELBOW AMPUTATION. 

Wilkin County, Minn., Jan. 26, 1896. 
A. A. Marks : 

Dear Sir : — I received my artificial arm in good condition. I like it verv 
much. It gives me great satisfaction. For the first time in four years I have 
been able to do almost any kind of farm work. 

Respectfully yours, 

N. O. Gronseth. 



440 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



MISSISSIPPI. 
ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Copiah County, Miss., Dec. 20, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I have been using one of your patent artificial legs for over 
fourteen years, and I have found it to be all you claimed it to be. I have 
done a great deal of heavy work on my farm since I have been using your 
artificial leg. My leg fits well. It has given perfect satisfaction. 

Thomas Graves. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Natchez, Miss., March 18, 1896. 
Mr. A. A. Marks : 

Dear Sir : — I wish to let you know how well pleased I am with my leg ; it 
has given entire satisfaction. A man who has never worn one of the ankle 
joint traps cannot fully appreciate the Marks leg. For eleven years I wore an 
ankle joint leg, and was never for more than a few days at a time free from 
suffering — it almost ruined my stump. I am happy to say that I have not had 
one of the old sores since I commenced using the Marks leg ; the rubber foot 
is a wonder. Very sincerely yours, 

G. L. Wood. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Monroe County, Miss., Nov. 15, 1895. 
Mr. A. A. Marks : 
Dear Sir : — I suppose you are aware of the fact that I have been wearing 




one of your artificial legs for over tour years ; I think myself the best one- 
legged man in Mississippi from the simple fact that I am wearing one of your 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 441 



artificial limbs. I am a barber by trade, I stand at my chair fourteen to six- 
teen hours each day and work hard. I have won two races here on my bicycle ; 
I can ride as far as any man in town and just a little faster. This is my first 
opportunity to tell you what I think of your limb. I remain, 

Your faithful patient, 

L. A. Carroll. 



MISSOURI. 



ABOVE-KNEE AMPUTATION. 

Phelps County, Mo., Dec. 18, 1895. 
A. A. Marks, Esq. , New York City : 

Dear Sir : — I take great pleasure in recommending your artificial limbs, 
especially for their durability and superiority of the rubber foot over all others. 
My left limb is amputated just above the knee joint. I have worn one of 
your limbs since April, 1884, and it has not cost me one cent for repairs to this 
date ; I walk easily without a cane, and have no difficulty in following my 
profession. Very truly yours, 

J. D. Carpenter, M. D. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Barry County, Mo., Dec. 17, 1895. 
Friend A. A. Marks : 

I have thoroughly tested your legs to my greatest satisfaction, in all kinds 
of weather. Their durability cannot be questioned, and your success in fitting 
and measuring has proven excellent. I can cheerfully recommend them to 
one and all. Yours respectfully, 

J. A. Grayson. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Franklin County, Mo., Dec. 19, 1895. 
Mr. A. A. Marks, New York : 

Dear Sir : — I have been using artificial legs for twenty-two years, and 
have had one from several factories, but none so well pleased me as yours. It 
was made by measurement, which proved satisfactory. I have used yours 
eleven years, and no repairing. I use it every day. The rubber foot is more 
durable than any other. Respectfully, 

Robert H. Hoffmann. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

St. Louis, Mo., June 17, 1894. 
Mr. A. A. Marks, New York : 

Dear Sir : — I wear my artificial leg all day and I have lots of walking to 
do ; I do it nearly as easily as before I lost my leg. The rubber foot seems quite 
natural ; I like it better every day. Yours truly, 

John C. Evans. 



ABOVE-ELBOW AMPUTATION. 

Fitted from Measurements. 

Dunklin County, Mo., July 14. 1S96. 
Dear Sir : — I have been wearing one of your make of artificial arms for 
two years and I can do almost as much labor with it as some people do with 



442 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



their natural arms. I am clerking in a store, handling all kinds of heavy- 
merchandise, I can wheel a wheel-barrow or hold a plow. I am well satisfied 
with my arm. (See cut No. 1103.) I am, 

Yours truly, 
A. A. Marks. W. C. Brat. 



MONTANA. 

BELOW-KNEE AMPUTATION. 

Sweet Grass County, Mont., Dec. 20, 1895. 
Mr, A. A. Marks : 

Dear Sir ; — The rubber foot you applied to my artificial leg gives me better 
satisfaction than I ever had with the ankle joint. I am now sure-footed, which 
I never was with the other. Yours, 

Jno. M. Dodge. 



KNEE-BEARING AMPUTATION. 

Jefferson County, Mont. , April 10, 1893. 
A. A. Marks, Esq. : 

Dear Sir : — In regard to my experience in using an artificial leg will say 
that I have worn an artificial leg thirty-one years. 

The first rubber foot I wore for twelve years, and the second to date. The 
rubber foot cannot be any more and be artificial. It gives a soft-like, safe step. 




No. 1216. 

I am a stone mason and builder. My work is on rough ground, with spall, 
fragments, and rubbish as usually seen about stone buildings while under con- 
struction. This is the place to test an artificial leg. No other leg ever did so 
much good. I will give a few rough ideas of the common sense of it. 1st, 
it has a stiff ankle joint which, though apparently a disadvantage, is really its 
charm. 

I can stand on the heel or toe at will ; this gives me great advantage in turn- 
ing about and getting around lively. The joint will flap on all other legs as 
soon as a little weight is applied to them. They will then be flat on the 
ground, and it will be impossible to turn until the weight is relieved. 

If on a sidehill, roof, or ladder the joint is not safe, but the rubber foot is 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 443 

always safe. Any person wanting to know about your limb I will cheerfully 
answer all communications if a P. O. stamp is inclosed. 

Kespectfully yours, 

Geo. D. Kerns. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Fergus County, Mont., March 8, 1896. 
Mr. A. A. Marks : 

Dear Sir : — The artificial leg received from you works splendidly, almost 
like a human limb. The rubber foot I consider a great improvement over the 
old one. Yours, 

W. E. Adams. 



NEBRASKA. 



ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Polk County, Neb., Aug. 7, 1896. 
Mr. A. A. Marks : 

Dear Sir : — This is to certify that in January, 1895, I purchased from you 
an artificial leg for a thigh amputation. Although being a man of 220 pounds' 
weight, I can truthfully say that I have not missed using it a day on account 
of any misfit or defect in workmanship. It is perfectly easy, being free from 
the annoying rattle that was connected with the other limbs which I have 
worn. Yours very truly, 

Harvey C. Beebe. 



ABOVE-KNEE AMPUTATION. 

Butler County, Neb., March 3, 1896. 
Dear Sir : — After wearing a limb for eighteen years I know how to appre- 
ciate one. Your foot movement is so noiseless and easy that I'd not think of 
going back to my old style. At first I thought I never could use it, but in a 
very little while I found I could. It has grown better and better right along. 
And now rather than go back to the old style I'd pay you $50 a year just for 
the use of yours, and I'm not rich either. Again, it pleases my friends ; they 
say I walk better, easier, etc. It is as much an addition to comfort in sitting, 
reclining, and walking, lifting, etc., as the limb itself. 

Yours truly, 

Rev. C. H. Dalrymple. 



ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Gage County, Neb., Dec. 19, 1895. 
A. A. Marks : 

Dear Sir :— I am a farmer ; have worn artificial limbs about sixteen years. 
I consider your artificial limbs superior to all others, as there are no ankle 
joints to wear out or clatter. The cost to keep your leg in order thus far has 
been comparatively nothing. Yours truly, 

Lansing Hinman. 



ABOVE-KNEE AMPUTATION. 

Lancaster County, Neb., Dec. 19. 1895. 
Dear Sir :— Your limb has given me good service. 

Respectfully, 

James Hill. 



444 A. A. MARKS, ARTIFICIAL LIMBS, NEW YOEK CITY. 



KNEE-BEARING AMPUTATION. 

Lincoln, Neb., Dec. 18, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I have worn artificial limbs for thirty-one years. During that 
time I have had three different kinds. The leg that you made for me is the 
boss ; I have worn it now for nine years, and I like it better every day. The 
rubber foot cannot be excelled. I walk two or three miles every day, going to 
and from my office, with perfect ease. My limb is amputated below the knee, 
and I use a knee-bearing limb, 

It fits me splendidly ; I do not have to wear straps or suspenders to keep 
it on. 

Respectfully yours, 

W. W. English. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Red Willow County, Neb., Dec. 18, 1895. 
A. A. Marks: 

Dear Sir : — I am well pleased with the artificial limb I purchased of you. 
Have worn it for ten years. It is apparently as good as when I first put it on. 
My occupation is agent and operator for B. & M. R. R. Co. I get around 
quite well. None of the railroad men know that I am a cripple, only those 
that I have told. 

Respectfully yours, 

Valentine Sells. 



BELOW-ELBOW AMPUTATION. 

Fitted from Measurements. 

Dodge County, Neb., Dec. 16, 1895. 
A. A. Marks : 

Dear Sir : — My arm I purchased about eleven years ago has far surpassed 
my expectations. 

My arm was amputated so close to my elbow that I have but very little con- 
trol over the joint ; notwithstanding I can make considerable use of the artifi- 
cial arm, the fitting is so well and the joints work so nicely. I was somewhat 
doubtful as to getting a fit from taking the measure myself. 

Results have shown that with ordinary care in measuring, following your 
instructions, one can be positively assured of a perfect fit. The rubber hand 
is something to be proud of ; with gloves on both hands it is almost impossible 
for a stranger to distinguish the difference. The hook, knife, fork, and brush 
accompanying the arm are very convenient. With the hook and ring I can 
pitch almost as much hay as I ever could. 

I handled lumber about two years in a lumber yard here, and never had a 
man in the yard that could handle a stick more in a day than I could. 
Yours very respectfully, 

A. W. Forbes. 



NEVADA. 

Washoe County, Nev., Oct. 25, 1895. 
A. A. Marks : 

Dear Sir : — I have worn one of your rubber feet for about two years. It 
remedies the defects of the ankle-joint leg previously worn by me. I can now 
ride a bicycle with anyone. I am, 

Yours truly, 

F. B. Porter. 



A. A. MAEKS, ARTIFICIAL LIMBS, NEW YORK CITY. 445 

BOTH ARMS AMPUTATED BELOW ELBOW. 
Written with a rubber hand. 

sLristsi+cC tA^Hi* yc^y ^pc^it^. <m,ir?u*/ ^^t^M- <&?r&iu 

O /ItSlMi /(flu* u*z&u fusty /^^Sj^^w^V*^*^**^ 




Ait ^&*B^y 

No. 1217. 

NEW HAMPSHIRE. 
BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Carroll County, K H., Dec. 19, 1895. 
A. A. Marks : 

Dear Sir : — I cannot see how you made such a good fit for me from measure- 
ments. The fit is so perfect the leg does not even feel strange to my stump. 
The leg enables me to walk so naturally my most intimate friends can hardly 
tell which is the artificial. Respectfully yours, 

Mrs. C. H. B. Whittler. 



446 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



BELOW-KNBB AMPUTATION. 

Fitted from Measurements. 

Cheshire Couhty, X. H., Dec. 30, 1895. 
A. A. Marks : 

Gentlemen : — In behalf of Mr. George H. Kimball of this city we desire 
to express our sincere thanks and hearty appreciation of the fine artificial limb 
received from you. For three months Kimball had been able to do nothing at 
all toward his own support, and had been just able to drag himself around 
on his old shattered apology for a limb with the help of two canes. The 
limb reached us at twelve and at two o'clock Mr. Kimball was around the street 
with only one cane, exhibiting his new acquisition. The next day, Saturday, 
he began work by sawing a cord of wood. He cannot now find words to 
express his gratitude to the friends who assisted him in procuring one of 
Marks' ^Nineteenth Century Triumphs. 

Thanking you for promptness and perfect satisfaction, we remain, 

Very respectfully, 

Bullard & Shedd, Druggists. 



BELOW-KNEE AMPUTATION. 

Dec. 16, 1895. 
A. A. Marks: 

Dear Slr : — I have worn one of your artificial limbs for more than four 
years. I am well satisfied with it and can recommend it to all. 

I walk three-fourths of a mile to my work and go over the road four times 
a day. 

Yours truly, 

Charles \V. "Walllngford. 
Strafford County, N. H. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Sullivan County, N. H., Mar. 11, 1896. 
A. A. Marks : 

Dear Sir : — I have worn the rubber foot you made for me nearly eleven 
years, and I am very much pleased with it. My foot was taken off about five 
inches above the ankle, and my weight is 24(fpounds. I am a machinist by 
trade, and can stand on my legat the vise or lathe all day with ease. I think 
the workmanship superior to any other make. I was surprised to have such 
a good fit by measure, as you never saw me ; but you made the leg by measure 
just as well as it could be' if I had been at your place. 

Very respectfully yours, 

F. A. Watress. 



NEW JERSEY. 

BOTH LEGS AMPUTATED BELOW THE KNEES. 

Middlesex County, N. J., Dec. 16, 1895. 
Mr. A. A. Marks : 

Dear Sir : — After twelve years' constant use in wearing a pair of your arti- 
ficial legs with rubber feet, I gladly bear testimony to their superior merits. I 
am able" to work all day and then walk a mile in eighteen minutes. My work 
being block-cutting, I am on my feet very often. My prior experience with 
other kinds tell me" of the difference between the comfort and the durability of 
each, and places your make far ahead of any other in every essential respect. 

I remain, 

Yours truly, 

Elijah Rhine. 



A. A MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



447 



LEG AMPUTATED BELOW THE KNEE, AND ARM AMPU- 
TATED ABOVE THE ELBOW. 

Somerset County, N . J. , Dec. 16, 1895. 
In 1859 I suffered the amputation of my right leg and right arm. As soon 
as practicable thereafter I had Mr. Marks apply his artificial limbs to me. At 
that time he was manufacturing artificial legs with ankle joints. In 18631 had 
one of his rubber feet applied. In 1865 I procured a new leg, and in 1871 I 
renewed the leg which I have worn ever since, during a period of twenty-five 
years. My experience wkh the old style of ankle joint and the rubber foot is 
of such a character as to compel me to speak in high praise of the rubber 
foot. 

Morris Force. 



ABOVE-KNEE AMPUTATION. 

Dec. 16, 1895. 
A. A. Marks, Esq. : 

I am still wearing the leg you furnished fourteen years ago. I have worn 
it comfortably with less than six dollars cost for repairs. My occupation 



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No. 1218. 



(house painter) gives it a good test. I can and do work on scaffolds, ladders- 
in fact anywhere. I have but a three-inch stump. I am well satisfied. 

Yours truly, 

Robert H. Perry. 
. Hudson County, N. J, 



448 A. A. MAEKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



ABOVE-KNEE AMPUTATION. 

Bergen County, N. J., Jan. 2, 1896. 
A. A. Marks, Esq. : 

Dear Sir : — I take pleasure in testifying to the satisfaction I have derived 
from the use of your artificial limb. I have worn Mr. Marks' artificial leg now 
for nine years with entire satisfaction. I wish particularly to recommend the 
rubber foot. It makes walking more natural and easy on account of its elas- 
ticity than a wooden foot, and more confidence can be placed in it. In my 
opinion it cannot be too highly recommended. I am, 

Yours, etc., 

Arthur Christie. 



ABOVE-KNEE AMPUTATION. 

Testimonial. 

1st. Occupation since wearing your artificial leg : Insurance agent and col- 
lector of taxes ; justice of the peace sixteen years*; light ordinary work ; 
cutting wood ; gardening ; gathering fruit, etc. 

2d. How long worn ? Since July, 1879. 

3d. Point of amputation : Left leg ; thigh ; eight inches below hip. 

4th. Comparative cost of repairs : No cost except for suspenders. 

5th. Other information : Worn constantly with great comfort, because of its 
light weight and soft, flexible rubber foot. I can truthfully testify with 
pleasure as above. 

Yours very truly, 



Hunterdon County, N. J. 



ABOVE-KNEE AMPUTATION. 



James Hoff. 



Dec. 19, 1895. 



Mr. Marks : 

Dear Sir : — In regard to limb I have of your make, words cannot express 
the satisfaction it has given me. I have worn it fourteen years constantly, and 
to-day can walk five miles, which is wonderful, I think, considering my limb 
is off above the knee-joint. I have had no repairs except for lengthening in 
that time. The rubber foot has no worthy rival. 

Yours respectfully, 

J. C. Green. 
Morris County, N. J. 



ABOVE-KNEE AMPUTATION. 

Union County, N. J., Dec. 16, 1895. 
A. A. Marks : 

Dear Sir : — I have worn your limb since 1867. I think the india-rubber 
foot is the greatest of inventions. It gives ease to the stump. No clicking in 
the ankle. I have a seven-inch stump above the knee ; left leg. I walk eight 
miles a day. 
My occupation is a farmer. I can walk without a cane. 

Charles Hehry Holmes. 



ABOVE-KNEE AMPUTATION. 

Union County, N. J., Jan. 3, 1895. 
Mr. A. A. Marks : 

Dear Sir : — The artificial leg is operating finely. I can walk with ease. 
It is next to impossible to detect any limp. I use a cane very little, for I can 
get along as well without it. 

Yours very truly, 

George. S. Everett. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 449 



KNEE-BEARING AMPUTATION. 

Passaic County, N. J., March, 1896. 
Mr. A. A. Marks : 

Dear Sir : — I will say that I have worn your legs for the last thirty-three 
years, and in that time put them to the severest test. Having worked at my 
trade, that of a machinist, up to a few years back, I have taken my part in 
handling the heaviest machinery in all conceivable positions both in marine 
engine building, locomotive work, and in pedestrianism. 

I have acted as a sewing machine agent in this and other cities, and would 
carry a machine on my back two and more nights of stairs and think nothing 
of it. The elastic rubber foot is one of the most charming features of your 
artificial limbs. 

Respectfully yours, 

James Rawson. 



BELOW-KNEE AMPUTATION. 

Dec. 23, 1895. 
Dear Sir : — Having worn your artificial limbs for over sixteen years, I 
would recommend them above all others for their strength and durability. I 
wore my first limb for over seven years, and in that time it has cost me just 
$1.50 for repairs. 

Yours, etc., 
Elizabeth, N. J. John J. Keily. 



BELOW-KNEE AMPUTATION. 

• Hudson County, N. J., Dec. 16, 1895. 
Mr. A. A. Marks : 

Sir : — I am well pleased with the limb and willing to testify to its merits. 
My work is felling and hewing timber, which is very laborious. The point 
of amputation is about seven inches below the knee. The cost of repairs has 
been comparatively nothing. 

Yours respectfully, 

Jonathan A. Baker. 



BELOW-KNEE AMPUTATION. 

Dec. 16, 1895. 
A. A. Marks : 

Dear Sir: — Having had your style of artificial limbs in use for twenty-eight 
years I find, after all these years, that I would not under any circumstances 
use any other make. I find it durable, easy, soft, and comfortable to wear. 
I have to put your limb to a very severe test, and it stands it nobly and satis- 
factorily. 

Yours, 
Jersey City, N. J. William Wick. 



BELOW-KNEE AMPUTATION. 

Jersey City, N. J., Dec. 22, 1895. 
Mr. Marks: 

I can cheerfully say that I have had the use of patented artificial legs for 
fourteen years, next February 14, and I can say that your artificial leg has 
given me the highest satisfaction. 

I lost my right leg about twenty-two years ago ; it was amputated three or 
four inches above the ankle joint, and ever since I have had your artificial leg 
I have followed the kalsomining trade for more than thirteen years. I put my 
leg on every morning, and continue my daily trade, going up and down my 
ladder from morning until night, both winter and summer. 

Yours truly, 

J. B. Cole. 



450 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



BELOW-KNEE AMPUTATION. 

Monmouth County, N. J., Dec. 16, 1895. 
Dear Sir: — I have been walking on one of your limbs ten years, and I like 
it very much, especially the rubber foot. It is the best, and I can walk all 
day without any pain. Yours, etc., 

D. C. Wood. 



Monmouth County, N. J., July 8, 1894. 
A. A. Marks : 

Sir : — I would not wear any other leg but yours, as I think it is just the 
right kind to have. I am driving a wagon and have been for the past three 




No. 1219. 

seasons. I have to jump in and out about sixty times a day besides climbing 
up stairs. The leg does not bother me and I have to move pretty fast some- 
times. Geo. A. Brewster. 



BELOW-KNEE AMPUTATION. 

Somerset County, N. J., Dec. 18, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I have worn one of your artificial legs for twenty-two years 
with very little repair. It has given me good satisfaction. Stump seven inches. 
I like the rubber foot very much. Yours, 

J. A. Van Nest. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Warren County, N. J., Dec. 19, 1895. 
Mr. Marks: 

Sir: — I am highly delighted with your leg. I have used an artificial limb 
since 1865, and about eleven years ago I got your patent, and I have more 



A. A. MAEKS, ARTIFICIAL LIMBS, NEW YOEK CITY. 451 



comfort than I ever had before. I can get around better, hunt the mountains, 
and feel at ease. 

Yours with respect, 

S. B. Danley. 



ABOVE-ELBOW AMPUTATION. 

Jersey City, N. J., Dec. 16, 1895. 
Dear Sir : — It was my lot to meet with an accident by which it became 
necessary to have my left arm amputated two inches above the elbow. I have 
been wearing one of your artificial arms for nearly ten years. I am well 
pleased with it. My position is book-keeping, and it is of great service to me, 
and as an ornament it is next to nature itself. 

Respectfully yours, 

Mary W. Ryan. 



BELOW-ELBOW AMPUTATION. 

Newark, Essex Co., N. J., Dec. 18, 1895. 
A. A. Marks, Esq.: 

Dear Sir : — On the second day of March, 1880, I lost my right hand in a 
mill, but with the artificial arm you made for me I am working at my trade as 
miller, and have not lost a day on account of the arm. Without the arm I 
would not be able to write these few lines to you. 

Respectfully yours, 

Louis Lueddecke. 



APPARATUS.— NO. 784 LEG. 

Burlington County, N. J. 
A. A. Marks : 

Dear Sir : — Having used your apparatus for deformed foot constantly for 
the past eighteen years, I can cheerfully say that it has answered the purpose 
intended, by concealing my deformity and enabling me to walk in a natural 
manner and without tiring. 

Yours respectfully, 
Dec. 16, 1895. Henry Sassaman. 



PARTIAL FOOT AMPUTATION. 

Ocean Grove, N. J., March 3, 1896. 
Mr. A. A. Marks : x * 

Dear Sir : — I am a printer by occupation ; my work is feeding and making 
up jobs on presses, lifting heavy newspaper forms, etc. Your new aluminum 
artificial limb constructed for me is a marvel, being light, neat, and strong. 
In fact, I cannot recommend it too highly. 

Yours respectfully, 

Wm. D. Newman. 



SECTION OF HAND, No. 1048. 

Essex County, N. J., Dec. 16, 1895. 
A. A. Marks : 
Dear Sir : — While out gunning I shot my right hand off nearly to the wrist. 
I gave up in despair, thinking my work was done for life, 1 being - a hatter 
and my work being done almost entirely with the right hand ; but after 
getting one of your rubber hands find I can do my work as well as ever with 
no inconvenience whatever. I have had it repaired once at a trifling cost . 

Yours truly, 

Geo. Grey. 



452 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



NEW MEXICO. 

ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Bernalillo County, N. M., May 22, 1893. 
Mr. A. A. Marks : 

Dear Sir : — I am well pleased with my artificial limb. I am getting along 
better than I expected, it fits me very well and hurts me nowhere. 

lam, 

Respectfully yours, 

Robert Purdy. 



NEW YORK. 

BELOW THE KNEE AND BELOW THE ELBOW AMPUTATIONS. 

Columbia County, N. Y., Dec. 16, 1895. 
Mr. A. A. Marks : 

Dear Sir :— I wish to add my name to your long list of grateful patients. 
One of my arms is amputated below the elbow and one of my legs is ampu- 
tated below the knee. I have worn the artificial leg and arm you made for me 
eleven years ago constantly, and have obtained great service from them. I am 
a very heavy man, weighing two hundred pounds, and am employed on the 
railroad. Respectfully yours, 

Henry E. Lowell. 



BOTH LEGS AMPUTATED BELOW THE KNEES. 

Tompkins County, N. Y., Dec~ 16, 1895. 
Mr. A. A. Marks, New York City : 

Dear Sir : — As far as the rubber feet are concerned, I shall say they are the 
best. They are to-day without an equal. I do hereby challenge any other 
maker in the world to produce a man that has a pair of artificial feet to walk 
with me. I do not take a back seat for any man that has got two good natural 
feet in a one-mile race. I will answer all communications sent to me by others 
in regard to the durability of the rubber feet. 

Respectfully yours, 

Thomas Cleary. 
(See cut No. 728.) 

(Extract taken from a local paper.) 
WALKING WITHOUT FEET. 

The Best vRecord Beaten. — A fair-sized audience assembled at Ithaca 
Rink last night to witness the effort of Thomas Cleary to beat the best mile 
walking record made by a man with artificial feet. Cleary, it will be remem- 
bered, suffered the loss of both feet some two years ago. 

At 9 p. m. " the man without feet" made his appearance upon the floor and 
began his task of endeavoring to beat the best record heretofore made. 

Mr. Cleary without apparent effort began his walk, going quite moderately 
at first, but as he neared the conclusion of the mile he quickened his pace and 
passed the mile-post in fine style in 16 minutes and 50 seconds, thus beating 
the best record by 2 minutes and 20 seconds, and making 17 laps in 17.10. 



BOTH LEGS AMPUTATED BELOW THE KNEES. 

Westchester County, N. Y., Dec. 17, 1895. 
Mr. A. A. Marks : 

Dear Sir :— Over twenty years ago I met with the misfortune of having both 
my legs crushed by the railroad cars, which necessitated amputation below the 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



453 



knees. I was then a mere lad, and did not fully realize the gravity of my 
misfortune. 

By the advice of my surgeons and others, I placed myself under your 
care for restoration. Your reputation as the one most competent in the 
land had so impressed me that, from the first, I felt that I was soon to realize 
the most that skill and ingenuity could possibly do for me. In this I have not 




No. 1220. 

been disappointed, for your labors have restored me to my feet, and I am, for 
all practical purposes, myself again. I well remember how proud I was when 
your genius placed me in a position in which I could indulge in youthful 
sports, how I availed myself of every advantage, playing ball, boating, fishing, 
and hunting in summer, and skating in winter. I even went so far as to swing 
my partner, on several occasions, in rural dances. 1 have always felt that your 
artificial legs were wonders, and ought to be known throughout the land. 

My latest fad is that of riding a bicycle. I found the task difficult at first, 
but I succeeded, after repeated attempts, to ride well and to enjoy it. 
Respectfully yours, 

James A. McDonald. - 



BOTH LEGS AMPUTATED BELOW KNEE. 

Allegany County, N. Y., Dec. 16, 1895. 
A. A. Marks, Esq. : 

Kind Sir : — I believe the rubber foot is the only kind of foot fit for use, es- 
pecially for a person that has lost both legs. I have tried several kinds and 
know whereof I speak. The last that you made for me is simply ' ' out of 
sight " compared with others that I have worn. 

Yours, 

► T. S. Tefft. ; 



454 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



ABOVE-KNEE AMPUTATION. 

Albany County, N. Y., Dec. 16, 1895. 
Mr. A. A. Marks : 

Dear Sib : — I have given my leg a thorough trial, having worn it for over 
eighteen years. I would not exchange it for any leg of other manufacture. 
The elasticity of the rubber foot is as natural as the real one, and the simple 
mode of construction makes the leg proof against getting out of order. 

I have never felt the need of an ankle-joint. I can go up and down hill with- 
out the joint better than with it. 

I can do almost all kinds of work with ease. My occupation is house car- 
penter, going up and down ladders, in fact doing all kinds of work, so that the 
durability of your patent has been fully tested by me. 
I can cheerfully recommend your limbs to all. 

Yours respectfully, 

Wm. Selkirk. 



ABOVE-KNEE AMPUTATION. 

Dec. 16, 1895. 
Mr. A. A. Marks : 
Dear Sib : — I have been using your artificial leg for twenty-two years. 
The rubber foot acts splendidly. I think it is as near perfection as anyone 
could wish for. My occupation, that of gate-keeper, requires me to be on 
my feet pretty much all the time. My leg was amputated about six inches 
below hip-joint, so I have but a very short stump to work on. 
I remain, yours respectfully, 

Cornelius Morrissey. 
Brooklyn, N. Y. 



ABOVE-KNEE AMPUTATION. 

Dec. 17, 1895. 
Mr. Marks: 
Dear Sir :— I have worn your artificial legs for about twenty-five years. 
I have a thigh amputation, a five-inch stump. I have worn five other legs 
of different makes, and I would not accept of any other leg, if I had to wear 
them if they were given to me. 
I am a carpenter and work at my trade. 

Respectfully yours, 
Brooklyn, N. Y. Abram D. Clark. 



ABOVE-KNEE AMPUTATION. 

, Brooklyn, N. Y., Dec. 18, 1895. 
A. A. Marks, Esq, : 

Dear Sib : — I have been wearing one of your limbs for nearly thirteen years, 
and am fully persuaded that they are the best made. At present I am in the 
lumber business, and find not the least trouble in getting over lumber and on 
to the highest piles we have in the yard. My leg is off above the knee, and I 
have considerable collecting to do and find no difficulty in walking any distance. 

Yours truly, 

F. T. Newcome. 



ABOVE-KNEE AMPUTATION. 

Broome County, N. Y. , Dec. 18, 1895. 

Dear Sir : — In the month of June, 1874, you made for me an artificial leg. 

It is now fast approaching twenty-one years, and during that time its use has 
been severe, constant, and protracted. My occupation has been largely that of 
gardening. I have picked most of my apples, going into the tops of the trees 
on a ladder, and picking from fifty to seventy-five bushels every fall. I have 
worn artificial legs for forty-three years, and ought to know something about 
them. 

Yours truly, 

To A. A. Marks, Esq. H. W. Parker. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



455 



ABOVE-KNEE AMPUTATION. . 

Dec. 19, 1895. 
A. A. Marks : 

Dear Sir : — I have been weariug one of your legs for over twenty-four years, 
and I would recommend them to anyone in need. As for comfort and natural 
walking, they cannot be excelled, and for durability they certainly cannot be 
equaled. I have had but two legs in nearly twenty-four years, and the one I 
am now weariug is good for four or five years yet, from all appearances. My 
limb is amputated four inches above the knee. 

Respectfully, 
Buffalo, N. Y. J. M. Palmatier. 



ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Chenango County, N. Y., Dec. 18, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I have worn your artificial legs for about twenty-three years, 
and they have done me first-rate service. 

They have all been fitted from measures. I have never been to your shop. 
My right leg was amputated at the thigh. I am a farmer and do all kinds of 
farm-work. I mow, cradle grain, hoe, etc., on one of your make of legs. 

Respectfully yours, 

Woodal Eastman. 



ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Chenango County, N. Y.. Dec. 29, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I have worn one of your artificial legs for nearly thirteen years, 
and am exceedingly well pleased with it. 

The rubber foot is a grand invention, no squeaking or getting out of order. 




No. 1221, 



It can be depended upon, and the knee-joint is the strongest and best I evei 
saw. I am farming and do all of my work, such as plowing, sowing, cradling, 
and everything that a farmer has to do. 

Yours respectfully, 

Charles E. Webb. 



456 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Delaware County, N. Y., Dec. 17, 1895. 
Mr. A. A. Marks: 

Dear Sir : — I believe your leg to be the best manufactured. My opinion is 
based upon my experience in wearing one of your full-length legs with rub- 
ber foot from about 1867 to the present time ; previous to that time I had 
worn several other makes. The rubber foot is much more durable, inasmuch 
as it does away with the necessity of so many cords and bolts, and at the same 
time imparts a more natural and elastic step ; it also sounds more natural 
when walking on the floor or pavement. My business heretofore has been 
farming and harness-making. As good a fit as I ever had was made by you 
by measurements. My leg was taken off at the upper third, leaving a stump 
about 7£ inches in length from my body. 

Yours, etc., 

J. A. Crawford. 



ABOVE-KNEE AMPUTATION. 

Office of Dr. H. Pearce & Co. , Druggists, Main Street, 

Pawling, Dutchess County, N. Y. , Dec. 17, 1895. 
Dear Sir : — I have worn artificial legs for about twenty-eight years, and 
one of Marks' patent for about twenty-three years. 
I regard yours far preferable to any other I have ever seen. 
My amputation is above the knee. 

Your leg is so simple and durable that there is no chance for anything to 
give out. 

Respectfully yours, 

Henry Pearce, M. D. 



ABOVE-KNEE AMPUTATION. 

Dec. 16, 1895. 
Mr. A. A. Marks : 

I am working in the store from 5 a. m. to 9 p. m. every day. I do not 
know what I would do without my ieg now. I have seen the limbs with 
. wooden feet, but I prefer Marks' rubber foot. It has not got that click-clack 
sound so often heard from others. 

William A. Kelly. 
New York City. 



ABOVE-KNEE AMPUTATION. 

March 4, 1896. 
Mr. A. A. Marks: 

Dear Sir : — I have worn the artificial leg you made for me for the past 
fourteen years. It has given me perfect satisfaction. It has cost me but little 
for repairs. I highly recommend it to anyone having use for same. As for 
me, I would wear no other. I am now employed on road and get around 
well. 

Yours respectfully, 
New York City. John J. Murphy. 



ABOVE-KNEE AMPUTATION. 

New York, Jan. 3, 1895. 
Mr. A. A. Marks : 

Dear Sir : — It is with a feeling of gratitude that I write to tell you how 
successfully you have restored me to a state of usefulness. My stump is only 
four inches long and I find no difficulty in walking five miles without tiring. 
I am the fortunate possessor of one of your New Mattress Rubber Feet. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 457 



The motion, action, and springy qualities of your new foot is unequaled, it 
helps the walking one hundred per cent., and is indeed a grand improvement. 
I am able to walk without a cane very naturally. In going up a hill the foot 
seems to act of itself, and in going over uneven sidewalks, rough ground, etc., 
there is no trouble whatever. The foot seems to meet all surfaces in a soft and 
yielding manner, without the slightest jar to the stump. 

Sincerely yours, 

S. H. Phillips. 



ABOVE-KNEE AMPUTATION. 

Dec. 28, 1895. 
A. A. Marks : 

Dear Sir : — Having worn your limbs for over twenty years, and being well 
pleased with them, I would not do without the rubber foot. I never saw a 
limb that equaled yours. I always got a good fit from you. My limb is 
amputated nine inches from hip joint. My business is traveling on the road 
selling stationary. I am on my feet a good deal and do lots of walking. 
You have my thanks and best wishes. 

Kespectfully, 
Norwich, N. Y. Edgar S. Kellogg. 



ABOVE-KNEE AMPUTATION.. 

Dec. 30, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I got one of your legs with rubber foot about twenty-five 
years ago, and have worn it most of the time. The amount of repairs on it has 
been light. I have worked at farming pioneered on the Western frontier, and 
hunted in the North Woods. I seldom use a cane, and friends remark how 
well I get around with it. My occupation is wood-sorting, which requires 
constant standing. For comfort and durability it has no equal. 

Chas. McDwoell. 
Oneida County, N. Y. 



ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Orange County, N. Y., Dec. 19, 1895. 
Mr. A. A. Marks : 

I purchased of you eighteen years ago last February an artificial leg which 
has been in constant use ever since. My work is in a creamery and cheese 
factory. The work is very heavy, and I am on my leg at least twelve hours 
every day. My limb was amputated within six inches of my body. Before 
purchasing this limb of you, I had two of another manufacturer, which only 
lasted about four years each. 

Very truly yours, 

John Roach. 



ABOVE-KNEE AMPUTATION. 

Queens County, N. Y., Dec. 18, 1895. 
Mr. A. A. Marks : 

Dear Sir :— In August, 1882, 1 lost my leg by an explosion in a drug store. 
Being young and my stump very short, I did not think that I could wear an 
artificial leg at all. In the spring of 1887 I received one of your full-length 
legs, which I now use and have been using every day since without any trouble. 
My occupation is a flagman and gateman, which requires me to walk across 
three railroads changing signals every three minutes for twelve hours every day. 

Yours respectfully, 

John H. SchafeS. 






458 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



ABOVE-KNEE AMPUTATION. 

Rockland County, N. Y m Dec. 27, 1895. 
I am very well satisfied with the artificial leg you made for me and take 
great pleasure in recommending it to others. 

Jeremiah Hanglon. 



ABOVE-KNEE AMPUTATION. 

Dec. 18, 1895. 
Mr. A. A. Marks, New York : 

Dear Sir : — While a policeman in New York City August 26, .1874, I had 
the misfortune to have both of my legs broken while on duty at the French 
dock, foot of Morton Street. After being in the hospital nearly a year, I had to 
have my right leg amputated four inches above the knee. In the spring of 
1876 I got of you a leg with a rubber foot. I think the leg and foot are the 
best made. 

Yours very truly, 
Suffolk County, N. Y. . Jasper G. Terry. 



ABOVE-KNEE AMPUTATION. 

Sullivan County, N. Y., Dec. 20, 1895. 
I have for the past eleven years used one of A. A. Marks' artificial legs with 
rubber foot. The finish, fit, and durability of these legs are, I have no doubt, 
superior to any other make, so much so that the expense for repairs during 
that time has been nothing. The amputation is above the knee, and although 
my work is rather laborious, so perfect is the fit and so suited the leg that I 
have had very little trouble. 

. D. M. SCRIBER. 



ABOVE KNEE AMPUTATION. 

"Westchester County, N. Y., Dec. 16, 1895. 
A. A. Marks : 

Dear Sir : — I had the misfortune to lose my right leg when I was six years 
old. At the age of eight I tried my first artificial limb. My profession com- 
pels me to be on my feet the greater part of the time. I feel no fatigue what- 
ever. I can say this, that having once used the Marks artificial limb I feel 
that I can never get along without one. 

Yours respectfully, 

Wm. B. Dayis, M. D. 



ABOVE-KNEE AMPUTATION. 

Wyoming County, N. Y., Dec. 16, 1895. 
A. A. Marks, New York City : 

I have worn your make of artificial leg for little more than nine years past, 
and I cannot speak too highly of the rubber foot. Although my work is not 
laborious I walk a great deal. I would recommend your make in preference 
to any other. Very respectfully, 

Mrs. J. W. DeRevere. 



KNEE-BEARING AMPUTATION. 

Madison County, N. Y., Dec. 16, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I have worn an artificial limb of your make for about twenty- 
three years. Previously I had worn one of a different manufacture, but I did 
not like it. Since wearing your make I have walked more easily and with no 
noise. Very truly yours, 

Rev. I. N. Clements. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 459 



BELOW-KNEE AMPUTATION. 

Dec. 16, 1895. 

I have now been wearing Marks' artificial limbs for over twenty-nine years, 
and proclaim their superiority over all others. 

Previous to using this I tried those of three other makers, but from none of 
them have I derived the comfort and satisfaction which I have from those of 
Marks. In my opinion they are the nearest approach to the natural limb 
of any that has yet been invented. I consider his rubber foot far ahead of any 
other contrivance to replace the natural foot. I have put them to the severest 
test, for during fifteen years of the time I have worn one of them my occupa- 
tion was of a very laborious character, and taken in connection with my 
weight, which always averaged two hundred pounds, was such as to try the 
merits of any limb. It has stood the test beycnd my expectations, and I con- 
fidently give the Marks limbs the preference before all others. 

James Boyle. 

Brooklyn, N. Y. 



BELOW-KNEE AMPUTATION. 

Dec. 16, 1895. 
Mr. A. A. Marks : 

Dear Sir : — About eighteen years ago I got one of your artificial legs, and 
have used it with but a very little expense. I walk so well, strangers do not 
believe I have an artificial leg. 

My weight is 225 pounds. I stand at my work (a marble turner) all day, and 
often for weeks I work fifteen hours a day. 

Yours most respectfully, 
Brooklyn, N. Y. Theodore W. Scott. 



BELOW-KNEE AMPUTATION. 

New York, Dec. 16, 1895. 
Mr. A. A. Marks : 
Dear Sir : — After using one of your artificial legs for several years I was 

induced by Mr. to purchase one of his make with ankle joint and wooden 

foot. It was not satisfactory, and after a thorough trial I had to condemn it 
and come to you again. The limb I am wearing at present time I have been 
wearing for the last sixteen years constantly without one cent of expense. 

Yours truly, 

Wm. C. Ditmar. 
Ferrymaster New York and Brooklyn Ferry Co. 



BELOW-KNEE AMPUTATION. 

Buffalo, N. Y., Dec. 16, 1895. 
I have worn your legs for thirty-six years, and commend them to all. 

Reuben Hall. 



BELOW-KNEE AMPUTATION. 

Buffalo, N. Y., Dec. 16, 1895. 
A. A. Marks, Esq.: 

Dear Sir : — My left limb was amputated eight inches below knee in 
1876. Since November of that year I have worn limbs with rubber feet, 
manufactured by you. 

The rubber foot so perfectly imitates the motion of the natural one that I take 
pardonable pride in walking on the streets, as I always do, without a cane. 
My work in the bank keeps me on my feet most of the day at the teller's desk, 
and also requires considerable walking in making our street collections. 

Yours respectfully, 

L. E. Munsell. 



460 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



BELOW-KNEE AMPUTATION. 

Chemung County, N. Y., Dec. 14, 1894. 
Mr. A. A. Marks : 

Dear Sir : — I desire to say in the fewest words possible that, after wearing 
three different legs, I am prepared to certify that for ease, comfort, and dura- 
bility your legs with rubber feet are, and of right ought to be placed at the 
head of the list. 
I have worn your leg over seventeen years. 

Theo. G. Smith, Deputy. 



BELOW-KNEE AMPUTATION. 

* Fitted from Measurements. 

Chemung" County, N. Y., Dec. 16, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I find your limb to be superior to the legs of other makers that 
I have used before. It is safe to stand or walk on. It does not produce the 
creaking and rattling noise which greatly annoyed me in the others. It is 
easily kept clean and in good working order. I am on my feet every day. 
My business is harness-making, and I cannot see but that my leg is as good 
now as it was when I commenced wearing it. I particularly recommend your 
success in fitting from measurements. 

Respectfully, 

Geo. W. Harvey. 



BELOW-KNEE AMPUTATION. 

Columbia County, N. Y., Dec. 16, 1895. 
Mr. A. A. Marks : 

Dear Sir: — I am a farmer, which has always been my principal business. 
For the past thirty- three years or more I have worn the rubber foot constantly. 
The elasticity of the rubber foot no doubt added much to its durability, and 
at the same time gave a more natural movement in walking, obviating the dis- 
agreeable thumping that attended the other foot I had used, and at the same 
time the jar to the natural limb, making it more comfortable and easy. 
I am, yours most truly, 

H. R. Hosford. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Columbia County, N. Y., Dec. 16, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I have been wearing limbs of your make for some twenty-four 
years, and have worn the old style with ankle joint. I can say that yours with 
rubber feet are far the best in all respects. 

The one that I now wear you made from measurements. It was a good fit, 
and is as good to-day as when I first put it on. I am a harness-maker. 

Respectfully yours, 

C. H. Groves. 



BELOW-KNEE AMPUTATION. 

Dutchess County, N. Y., Dec. 16, 1895. 
A. A. Marks : 

Dear Sir : — I am more than pleased with my leg. I have worn your cele- 
brated leg with rubber foot for the last seventeen years. 

I have had severe trials ; my leg could stand them, and I am certain that I 
can appreciate it as the best artificial leg ever patented. 

Yours truly, 

HlRBEN H. OSTRANDER. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 461 



BELOW-KNEE AMPUTATION. 

Dutchess County, N. Y., Dec. 17, 1895. 
Mr. A. A. Marks : 

Dear Sir : — 1 have used four of your legs, and find them satisfactory in every 
respect. 

I want no ankle joints. The rubber foot is the best improvement yet. As 
for repairs, it has not cost me over $3 for all. 

I am standing all day at my work. I have used patent artificial legs since 
1864, and yours gives the best satisfaction of any. 

Yours truly, 

Rupus Tilbe. 



BELOW-KNEE IMPUTATION. 

Franklin County, N. Y., Dec. 14, 1895. 
A. A. Marks, Esq.: 

Dear Sir : — I have worn an artificial leg for the past thirty years. During 
the first fifteen years I tried various makes, but was always annoyed after 
wearing one but a short time by the joints in the foot becoming loose, and 
"rattling," or " clicking" at every step. Your rubber foot is entirely noise- 
less, and does away with the above very serious objections. 

The elasticity of the rubber fully takes the place of joints in the foot and 
ankle. But more than anything else I value your make because of its perfect 
fit and stability. While standing on a moving wagon, car, or ferryboat, there 
is none of that "waving," or " see-sawing " motion so common and noticeable 
in wearers of all other makes. I weigh 175 pounds, and for four years was 
salesman in a dry goods store, and on my feet from twelve to fifteen hours 
a day. Yours very sincerely, 

Isaac M. Warren. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Madison County, N. Y., Dec. 20, 1895. 
Mr. A. A. Marks : 

Dear Sir :— My wife has worn the artificial leg we bought of you since 
receiving it (the 1st of November, 1887) with perfect satisfaction. It works 
well and no signs of wear. We are well pleased, and wish you every success. 

Respectfully yours, 

K. E. Cardner. 



BELOW-KNEE AMPUTATION. 

r - New York City, Dec. 16, 1895. 

A. A. Marks : 

Dear Sir : — I have worn an artificial limb for the last twenty-threeyears, and 
for the last twelve years have been wearing one of yours with rubber foot. 

With my experience I consider your artificial limb with rubber foot far su- 
perior to any I have used, and recommend it to my patients. I can walk much 
better than I ever could before. Expenses for repairs are almost nothing. 

Yours, etc., 

Dr. G. W. Nelson. 



BELOW-KNEE AMPUTATION. 

Dee. 16, 1895. 
A. A. Marks, Esq : 

Dear Sir : — In my thirty years of experience with your artificial legs I can 
safely say that I have seen a couple of hundred persons with artificial limbs 
of other makers, and from my own experience will say without fear of con- 
tradiction that none of them are as perfect as yours with the rubber foot. 
I remain, 

Yours respectfully, 
New York City. Joseph Batey. 



462 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

BELOW-KNEE AMPUTATION. 

New York City, Jan. 2, 1895. 
A. A. Marks : 

I lost my leg below the knee from gunshot wound received in the late war. 
As soon as my stump healed, the United States Government presented me with 
one of 's legs with an ankle joint. I wore it for a short time, and thought 




No. 1222. 

I liked it, but when I had one of your rubber feet applied to it I at once dis- 
covered that I had bettered my condition. I have worn your rubber foot 
now about twenty-eight years, am a machinist, and work at the lathe and 
forge. For ten years I worked on a foot lathe, doing the treading with my 
rubber foot. 

"William Dietze. 



BELOW-KNEE AMPUTATION. 

Dec. 17, 1895. 
A. A. Marks, Esq.: 

Dear Sir : — I have been wearing your make of legs for twenty-eight years. 
My stump is one inch below the knee. I have marched in a parade in this 
city from Fifty-ninth Street to the Battery, and return. Phil. Kearney Post, 
to which 1 belong, in this city, can vouch for the above. 

I remain, yours truly, 



New York City. 



A. Hatjsbeck. 



BELOW-KNEE AMPUTATION. 

New York City, Dec. 16, 1895. 
A. A. Marks,, Esq : 

Dear Sir : — I am pleased to report that with your patent rubber-foot leg I 
have been especially pleased. I am not only able to attend to my business, but 
can indulge in a good long walk occasionally, and enjoy myself in other re- 
spects. I can walk better and further on your legs than on any of the old 
styles I have worn, the action of the foot being natural and noiseless, suffi- 
ciently so to deceive the closest observers. 

Respectfully yours, 

J J. EOAN. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 463 



BELOW-KNEE AMPUTATION. 

New York City, Jan. 1, 1896. 
Mr. A. A. Marks : 

Dear Sir ; — Have worn your patent artificial legs for nearly fourteen 
years, and will make application for a new one from the Government just as 
soon as the time comes. I have only about three inches below the knee. I 
am on my leg twelve hours every day. 

Yours truly, 

John J. Wilson. 



BELOW-KNEE AMPUTATION. 

New York City, Dec. 17, 1895. 
Mr. A. A. Marks : 

Dear Sir : — After an experience of over twenty-two years in the use of your 
patent artificial leg with rubber foot, I desire to say that it has given me first- 
rate satisfaction. About eighteen years ago I was induced to purchase a leg of 

Mr. 's make, with his wooden foot and ankle joint. After using it for 

nearly two years with constant repairs, I abandoned it, and am now using yours 
again. That trial was enough for me; I want no more ankle- jointed wooden 
feet for me on an artificial leg, so long as yours are to be had, as my own 
experience proves their superiority. 

Chas. Libenau, M. D. 



BELOW-KNEE AMPUTATION. 

New York City, Dec. 18, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I have been wearing one of your artificial legs with patent 
rubber foot (amputated below the knee) twenty-eight years. I can say from 
observation and inquiry with those who are wearing artificial legs, and I know 
many, that the one I wear (your patent) is in every respect superior, more 
durable, less liable to get out of order, than any artificial leg I have seen or have 
any knowledge of. 

Truly yours, 

Sam'l Truesdell, 
Pension Agent, New York Agency. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Niagara County, N. Y., Dec. 26, 1895. 
Mr. A. A. Marks, New York : 

Dear Sir : — The leg you furnished me, from measurements sent you, fitted 
perfectly and has given me the best of satisfaction. 

Yours truly, 

Patrick Clark. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Oneida County, N. Y., Dec. 20, 1895. 
Mr. A. A. Marks : 

Dear Sir : — Having used others with ankle motion, I am able to judge the 
difference and advantages of your patent rubber foot. There is no rattling or 
breaking down. I have given yours nearly twenty-eight years' trial. and in so 
doing have proved the real merits and great satisfaction it has given me. I 



464 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



have done all kinds of heavy shop work on it with comparatively no diffi- 
culty, with amputation five inches below the knee. My leg was fitted from 
measurements. I can work on the roof of a building with ease. 

Yours respectfully, 

D. M. Green. 



BELOW-KNEE AMPUTATION. 

New York City, Jan. 28, 1888. 
A. A. Marks : 

Dear Sir : — I have worn one of your rubber limbs for about fifteen years 
with entire satisfaction. My occupation is truckman for the New York Belt- 



No. 1223. 

ing and Packing Company. I help in loading my own truck and frequently 
lift bales of several hundredweight. 
The limb has been in constant use. 

Eespectf ully yours, 

C. H. Brewster. 



BELOW-KNEE AMPUTATION. 

Onondaga County, N. Y., Dec. 16, 1895. 
A. A. Marks : 

Dear Sir: — I have worn your legs nearly twenty-eight years and have 
worked at nearly all kinds of work. I think they are the best. 

Respectfully yours, 

N. Reynolds. 



BELOW-KNEE AMPUTATION. 

Dec. 16, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I have used one of your patent limbs for ten years, and have 
found it perfectly satisfactory, 

Yours truly, 

John M, Milspaugh. 
Orange County, N. Y. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 465 

BELOW-KNEE AMPUTATION. 

Orange County, N. Y., Dec. 16, 1895. 
A. A. Marks : 

Dear Sir :— On April 9, 1865, 1 lost my right leg at Sumterville, S. C, and 
have used artificial legs for thirty years. 

I have seen about all the different kinds of legs made, and must say that I 
consider yours the best. My amputation is two and one-quarter inches below 
the knee, and my business requires me to be on my feet from 5 a. m. to 10 
p. m. daily. 

Very respectfully, 

Joseph Lomas. 



BELOW-KNEE AMPUTATION. 

Dec. 20, 1895. 
Mr. A. A. Marks: 

Dear Sir : — I have used one of your artificial legs fourteen years, and 
the second one you fitted me with I have used three years. After using 
other artificial legs with ankle joint, I am convinced that your patent leg with 
rubber foot is the best artificial limb manufactured in this or any other coun- 
try. Point of amputation, six inches below the knee. Occupation, harness- 
maker. 

Yours truly, 

Abraham Evans. 
Orange County, N. Y. 



BELOW-KNEE AMPUTATION. 

Putnam County, N, Y., Dec. 16, 1895. 
Mr. A. A. Marks : 

Dear Sir : — The leg you made for me in 1872 has been in every-day use 
from that time till now, and is a good leg yet. 

The expense for repairs has been less than a dollar per year. 

Yours, etc., 

W. Pepper. 



BELOW-KNEE AMPUTATION. 

Rensselaer County, N. Y. , Dec. 16, 1895. 
A. A. Marks, Esq., New York City : 

Dear Sir : — I have worn the limb that you made for me in 1863 every day 
up to November 6, 1895, or about thirty years. 

It did not cost me to keep in repair during all that time twenty-five dollars, and 
while I weighed only about 140 pounds when I first commenced wearing it, my 
weight increased to over 220 pounds. My new leg of 1893 gives the same 
satisfaction. My business has been laborious and active. 

Michael Vaughn. 



BELOW-KNEE AMPUTATION. 

Richmond County, N. Y., Dec. 16, 1895. 
Sir : — I have used the Marks leg for thirty -four years. 

It cannot be excelled ; I have used one continuously for ten years without 
having any repairing. Your legs have given me the greatest satisfaction ; as 
for durability they have no equal. 
There is no foot in my opinion that can compare with the rubber foot. 

Respectfully yours, 

John S. Bowne. 



466 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



BELOW-KNEE AMPUTATION. 

Rockland County, N. Y., Dec. 17, 1895. 
Mb. A. A. Marks: 

Dear Sir : — Having used one of your patent artificial legs with rubber foot 
some twenty years, I consider that a fair trial. I am a farmer, and have had 
little or no expense attending the use of the leg. I cheerfully recommend your 
work. 

Truly yours, 

C. R. Mertlne. 



BELOW-KNEE AMPUTATION. 

Schenectady County, N. Y., Dec. 16, 1895. 
Mr. A. A. Marks : 

Dear Sir : — The artificial leg that you made for me seven years ago has 
proved perfectly satisfactory, and far exceeds anything I ever anticipated in 
taking the place of the limb I lost about eight years ago while on duty, as 
brakesman for the New York Central & Hudson River R. R. 

Yours, 

Chas. Wing. 



BELOW-KNEE AMPUTATION. 

Schuyler County, N. Y., Dec. 19, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I have worn the leg you made for me for about eleven years, and 
I think it is good for a year or so longer. I have never worn any other and have 
no desire to, as I believe your rubber foot is easier to walk on, more durable, and 
much more natural than any other kind. I go up and down stairs the same as 
people with natural feet, I ride a bicycle, skate on ice and roller skates, and I 
can run so that I make some people hustle to keep up with me. I had my leg 
fitted from measurements, and it works like a charm. My leg is off about four 
inches below the knee ; the cost for repairs has been too slight to mention. 
I now own the best livery in front of the Northern Central R. R. station here. 

Yours respectfully, 

Edward Bertholf. 



BELOW-KNEE AMPUTATION. 

July 8, 1896. 
A. A. Marks : 

Dear Sir : — My experience in wearing your leg is such that I cannot say 
too much in its praise. In 1872 I first got my artificial leg from you. For the 
first twelve long years I wore that leg every day ; the first four years I built 
bridges, graded streets, and dug sewers in the city of Utica. The next three 
years I kept a hotel. The next five years I boated on the Erie Canal. 

During the twelve years it did not cost me a dollar for repairs, but at the end 
of that time it was nearly worn out. I repaired it myself. Finally I replaced 
it by a new one. 

Respectfully yours, 

John McCue. 
Seneca County, N. Y. 



BELOW-KNEE AMPUTATION. 

St. Lawrence County, N. Y., Dec. 19, 1895. 
Mr. A. A. Marks : 

Dear Sir :— I feel as though I ought to thank you for the success yon have 
had in fittting me with an artificial limb. I believe no other limb that I have 
seen could take the place of the rubber foot. I have worn an artificial limb for 
the past thirty years. 



A. A. "MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 467 



I am a laborer and often lift heavy articles, such as barrels of -sugar and all 
kinds of freight. I would advise all who are so unfortunate as to be obliged to 
wear an artificial limb to try your rubber foot. I remain, 

Yours very respectfully, 

A. H. Armstrong. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Steuben County, N. Y., Dec. 16, 1895. 
A. A. Marks, Esq. : 

Dear Sir : — The leg you fitted by measurements for me is fine. I am a 
cabinet maker by occupation. I have used artificial legs thirty years. I have 

had three of Marks', one of , and like yours much the best. Leg off eight 

inches below the knee. I have worn your leg twenty-six years at a cost of 
less than one dollar and fifty cents a year. I like your leg well enough to buy 
when this gives out. 

Yours very truly, 

P. P. Laird. 



BELOW-KNEE AMPUTATION. 



Dec. 16, 1895. 



A. A. Marks, Esq. , New York : 

Dear Sir : I have been wearing one of your artificial legs, with rubber foot, 
for the past ten years, and now have my second leg. I use no cane or other 
assistance in walking, and can walk a mile in fifteen minutes. I frequently go 
trout-fishing, and walk ten miles. I am perfectly at home on roller skates, and 
in fact can perform any work I ever could before amputation. 

I have known persons three years who never knew I wore an artificial limb, 
and would not believe it until they saw it, as there is nothing in my walk to 
indicate my misfortune. 

Yours truly, 

Ira W. Schaffer, 
Pumping Engineer. 
Steuben County, N. Y. 



BELOW-KNEE AMPUTATION. 

Suffolk County, N. Y., Dec. 16, 1895. 
For the last twenty years I have used one of A. A. Marks' artificial limbs 
with rubber foot with satisfactory results. 

No rattling hinges or squeaking joints to annoy me, I can recommend your 
leg to all who contemplate getting a limb. 

Yours, 

Geo. W. Kinner. 



BELOW-KNEE AMPUTATION. 

Tioga County, N. Y., Dec. 25, 1895. 
Mr. Marks : 

Sir :— I have worn one of your artificial limbs with rubber foot for ten years, 
and found it one of the greatest blessings this world affords. I have done the 
work of six in the family, and taken care of the milk and butter of nine cows 
this summer. I have not been to any expense for my foot since I got it. My 
leg was amputated about one inch and a half above the ankle joint." 

Yours respectfully, 

Mrs. G. M. Smith. 



468 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



BELOW-KNEE AMPUTATION. 

Ulster County, N. Y., Dec. 17, 1895. 
A. Af Marks : 

Dear Sir : — My wife had her limb amputated in Roosevelt Hospital in New 
York City, July 15, 1882. 

One year afterward she commenced wearing one of your limbs, and is wear- 
ing it now with ease, doing all her housework, up and down stairs. Limb 
was amputated below the knee joint. I am 

Respectfully yours, 

Martin R. Nilan. 



On the evening of June 7, 1888, Johnny Carey stole into the yards of the 
railroad depot at Utica, N. Y. , with an arm full of papers. It was his inten- 
tion to board an express train which was about due. The train was late. 
Johnny sat upon the platform step and fell asleep. When the express came it 
ran over his leg and mangled it in a frightful manner. Johnnie's first thought 
was that the yardmaster had got hold of him and that he had better get out of 
the way. In his efforts to get up he was brought to realize the fact that he had 
been run over. The depot men picked him up and took him to a neighboring 




No. 1224. 

hospital, where the surgeons amputated the mangled leg. Johnny made 
a quick recovery and soon got about on crutches. A few sympathizing friends 
contributed enough money to buy one of Marks' artificial legs. Johnny soon 
learned to walk, and resumed his newspaper traffic. Ever since then he has 
been going about so naturally and comfortably that nobody suspects that he is 
the same Johnny Carey who met with the frightful accident in 1888 ; he is able 
to run, walk, jump on and off cars just as well as other boys, and he manages 
to sell as many papers as any of his fellow-newsboys. 



BELOW-KNEE AMPUTATION. ' 

Dec. 17, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I have worn one of your artificial legs thirteen years. I am 
yardmaster of the Ulster and Delaware Road, and on the go from twelve to 
fourteen hours every day, and have not lost a day since I got your leg. . . My 
leg is amputated about four inches above the ankle. I was perfectly fitted 
from measurements, and I have not had any trouble with the stump since I 
have worn this leg. I remain, 

Yours truly, 
Ulster County, N. Y. John Lounsberry. 



A. A. MAKKS, ARTIFICIAL LIMBS, NEW YOEK CITY. 469 



BELOW-KNEE AMPUTATION. 

Dec. 16, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I have been using one of your artificial limbs for more than a 
decade, and find it answers fully to everything you claim, durability, neatness, 
etc. I am on my feet the most of my time, and walk a great deal, and find no 
inconvenience. 

My leg is amputated about five inches below the knee. The cost for repairs 
is very small. It is a grand success. I remain, 

Truly yours, 

Hugh Dick. 
Ulster County, N. Y. 



BELOW-KNEE AMPUTATION. 

Ulster County, N. Y., Dec. 17, 1895. 
Dear Sir : — My occupation is harness maker. 1 have worn your artificial 
leg almost twenty -four years. I am satisfied that for endurance your patent 
artificial leg cannot be beat. 

Yours truly, 

August Grosch, Jr. 



BELOW-KNEE AMPUTATION. 

Westchester County, N. Y., Dec. 16, 1895. 
Mr. Marks: 

Dear Sir : — I work at most everything that gives your leg a hard trial, such 
as working on a thirty-foot ladder at painting in the warmest of weather. Last 
winter I drove a wagon and was out all kinds of weather, but it still holds 
well. My limb is off six inches below the knee. I remain, 

Respectfully yours, 

Joseph Pugmire. 



PARTIAL FOOT AMPUTATION. 

Brooklyn, N. Y., Dec. 18, 1895. 
A. A. Marks : 

Dear Sir : — I have worn some sort of an appliance for a Chopart's* amputa- 
tion for upward of twenty-seven years, and of course I know something about 
such things, and I will say that before I secured one of your appliances, I 
could never get one that would not break every little while. The fault always 
lay in the effort to work in the ankle-joint motion which is of no consequence 
with your rubber foot— certainly for more than twelve years I have had no use 
for the ankle-joint motion while wearing your rubber foot. 

Your rubber foot attached to the wood socket seemed to me to be the height 
of perfection, but your rubber foot attached to the aluminium socket is a vast 
improvement, because it has reduced the size of the foot about the ankle so 
much. The socket fits the shin like a glove to the hand. This result I found 
because I have a very tender shin bone. 

Very truly yours, 

W. P. Eddy. 



ANKLE-JOINT AMPUTATION. 

40 Pacific St., Brooklyn, N. Y.. Dec. 19, 1895. 
Mr. A. A. Marks : 

I have worn the rubber-foot leg you made for me twenty-two years. It has 
given me perfect satisfaction. I heartily recommend it. I lost niv foot in the 
U. S. Navy. 

James Connell. 



470 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITT. 



ANKLE-JOINT AMPUTATION. 

Dutchess County, N. Y., Dec. 31, 1895. 
Mr. A. A. Marks : 
Dear Sir : — I have worn your leg constantly for ten years. 
I walk with safety and comfort, and no repairs needed ; yet I do a great deal 
of walking. 

I remain, very truly yours, 

Julia Emery. 



ANKLE-JOINT AMPUTATION. 

Westchester County, N. Y., March 22, 1896. 
Mr. A. A. Marks : 

Dear Sir :— I sell morning papers on the R. R. trains, get on and off while 
the train is in motion, and wear one of your rubber feet ; very few of my 




friends know of the fact, and those who do regard me as the possessor of a 
remarkable foot. I experience no inconvenience ; I heartily recommend your 
leg as the best made. 

John Scharff. 



ANKLE-JOINT AMPUTATION. 



March 3, 1896. 
-My foot was amputated at the ankle joint, called the Syme's 



Mr. Marks : 

Dear Sir :- 
amputation. I have worn several different kinds of artificial limbs since 1868, 
but prefer yours to any I have had. I would not wear a foot with an ankle 
joint if it were given to me. I have worn yours and worked with it every day 
for seventeen years in the Delamater Iron Works, foot of West 13th St., New 
York City, and found it perfect in every respect. 

Yours respectfully, 

F. W. Funch. 

New York City. 



ANKLE-JOINT AMPUTATION. 
Mr. Marks : 

Dear Sir : — I am a farmer ; in March, '86, I out one of my feet so badly 
with an ax that amputation was necessary. On^Iarch 29 a Syme's amputa- 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 471 



tion was performed. In August following I purchased one of your artificial 
limbs, and must say it gives me entire satisfaction. I am able to do almost 
all kinds of farmwork, and walk a mile very comfortable. Indeed many 
strangers are surprised when they find that I am wearing an artificial limb. 

Very respectfully, 



Suffolk County, N. Y., Dec. 16, 1895. 



INSTEP AMPUTATION. 



Theo. O. Hulse. 



Dec. 16, 1895. 



Mr. A. A. Marks, New York : 

Dear Sir : — Previous to buying my foot from you I visited all the prin- 
cipal makers in New York, but found nothing I liked so well as the foot I saw 
at your place. I am now employed as salesman, and do a great deal of walking 
and standing. I get along almost as well as ever I did, without any limp or 
halt whatever, and a person not knowing the fact would never suspect there 
was anything wrong. 

I am, yours truly, 

New York City. Robert Loeb. 



ANKLE-JOINT AMPUTATION. 

Mount Vernon, N. Y., Dec. 26, 1895. 
A. A. Marks. * 

Dear Sir : The aluminum artificial leg you recently made for me is all that 
it could possibly be. It is a strong, light, neat, and efficient limb, and I wish 
to express my great pleasure and heartfelt thanks. 

Very respectfully, 

William Marshall. 



ANKLE-JOINT AMPUTATION. 

New York, Dec. 16, 1895. 
A. A. Marks : 

Dear Sir : — I congratulate you on your latest award. My foot I got of you 
some time ago is giving entire satisfaction and gets lots of hard wear daily. 

A. F. Todd. 



ANKLE-JOINT AMPUTATION. 

Brooklyn. N. % \, Dec. 20, 1895. 
Messrs. A. A. Marks : 

Dear Sir : — I am very well satisfied with the aluminum leg. My occupa- 
tion is in a carpenter shop doing a little of everything as a helper, where I 
sometimes have to carry considerable lumber on my shoulder, and I find no 
difficulty in walking. 

I remain, yours truly, 

James Dunden. 



BELOW-ELBOW AMPUTATION. 

Dec. 16, 1895. 
Mr. A. A. Marks : 

Dear Sir : — The artificial arm you made me about eight years ago is giving 
complete satisfaction ; I would not know how to do without it. I find it very 
useful in my work. 

Yours respectfully, 
Chemung County, N. Y. H. A. Leese. 



472 A. A. MAEKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



BELOW-ELBOW AMPUTATION. 

Fitted from Measurements. 

Chemung County, N. Y., Dec. 12, 1895. 
A. A. Marks, Esq. : 

Dear Sir : — I take great pleasure in testifying to the merits of your artificial 
limbs. I am wearing one of your rubber hands, and from my experience and 
in comparing it with others, I heartily recommend its superiority. 

I have worn it every day for nearly twelve years, and with the expense of a 
few dollars upon the suspenders have kept it in such good repair that many 
have been surprised upon learning that I have an artificial limb. My arm was 
amputated just above the wrist. 

Yours very respectfully, 

Eugene Atkins. 



BELOW-ELBOW AMPUTATION. 

Columbia County, N. Y.,' Jan. 11, 1896. 
Mr. A. A. Marks : 

Dear Sir : — I respectfully state that I am now using, and have used for the 
last twelve yeaTs, one of your patent artificial arms with rubber hand. I have 
never worn any other. I would not do without mine by any means. 
Yours respectfully, 

Wm. B. Holsapple. 



BELOW-ELBOW AMPUTATION. 

Fitted from Measurements. 

Delaware County, N. Y., Dec. 23, 1895. 
Mb. Marks : 

Dear Sir : — The artificial arm you made for me seven or eight years ago 
gives perfect satisfaction. I am a farmer and do most all kinds of work with 
it and its attachments. Yours respectfully, 

J. A. Hendry. 



kELOW-ELBOW AMPUTATION. . 

New York City, Dec. 16, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I well know that Edward Wiley, who is now absent, is satisfied 
with his hand; he is able to drive a team of horses, and do other farm work. 

Yours obediently, 

Samuel Rapp, M. D. 



BELOW-ELBOW AMPUTATION. 

New York City, Dec. 16, 1895. 
A. A. Marks : 

I have worn one of your artificial arms with rubber hand for fifteen years, 
and found it very satisfactory in every respect. 

Until a short time since I was manager of a large branch telegraph office, 
and I found the arm a great help to me in my duties. 

I put a pencil in the rubber hand, between the fingers, and used it to time 
the message, while sending with the other hand. 

Yours very truly, 

L. Leslie Lathrop. 



BELOW-ELBOW A31PUTATI0N. 

Ontario County, N. Y., Dec. 19, 1895. 
A. A. Marks, Esq.: 

Dear Sir : — I take pleasure in testifying to the satisfaction I have derived 
from the use of your artificial arm, my arm being amputated two inches above 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 473 



the wrist joint. I have worn the arm you made for me nearly thirteen years, 
with perfect ease from the first day. I have worked for the N. C. R. Co. as 
freight inspector and car sealer ever since I purchased my arm. I could not 
do my work without the hand. I believe your rubber hand and arm to be 
the most perfect and most durable of any I have ever seen. I am more than 
pleased with it, and money could not buy it coulQ I not get another. 
I remain, respectfully yours, 

J. E. Carr. 



BELOW-ELBOW AMPUTATION. 

Fitted by Measurements. 

Oswego County, N. Y., Dec. 23, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I have been wearing the artificial arm you made for me now 
for ten years, and am very much pleased with it. , Your rubber hand is very 
convenient. I do not know how I would get along without it. I can farm 
the same as ever. 
The hook arrangement is just the thing for the farmer. 
Respectfully yours, 

Irving R. Williams. 



BELOW-ELBOW AMPUTATION. 

Schoharie County, N. Y., Dec. 16, 1895. 
Mr A. A. Marks : 

Dear Sir : — I am well pleased with my artificial arm I bought of you thir- 
teen years ago. I use the nickel-plated hook to great advantage. I am a 
farmer, and can do nearly all kinds of work. 

Respectfully, 

Matthias Terrell. 



BELOW-ELBOW AMPUTATION. 

Sullivan County, N. Y., Dec. 16, 1895. 
Mr. A. A. Marks : 

Dear Sir :— I am very much pleased with my arm. It is so light, con- 
venient, and is worth thousands of dollars to me. 

The new attachment that you have made is so comfortable that I can keep 
it on day and night. I keep a general country store, and do all the work 
myself. I remain, yours very respectfully, 

N. Kurz, Jr. 



BELOW-ELBOW AMPUTATION. 

Fitted from Measurements. 

Wyoming County, N. Y., Dec. 16, 1895. 
A. A. Marks, Esq. : 

Dear Sir :— Am pleased to say the arm I bought of you six months ago has 
proved satisfactory in all you claim for it. I am now able to fill regular desk 
in freight office, doing all kinds of work requiring use of both hands. 

My arm was amputated just below the elbow, and before purchasing your 
arm I was unable to get anything to do better than night watchman. 

Yours truly, 

Bruce M. Walker. 



WRIST AMPUTATION. 

Brooklyn, N. Y., Dec. 17, 1895. 
Mr. Marks : 

Dear Sir : — After using your rubber hand for the past nine years I take 
great pleasure in stating that it is far superior to what you claim/ I am more 



474 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



than satisfied and would cheerfully recommend your hand to anyone who has 
been unfortunate enough to have lost one. 

Respectfully, etc., 

John B. Bradshaw, 

Engineer Str. Gov. Hill. 



WRIST AMPUTATION. 

Dec. 18, 1895. 
Dear Sir:— My occupation is a sawyer. I lost my hand at the wrist on 
April 12, 1882, by sawing timber. Two months after I got one of your arti- 
ficial arms, which I found very valuable. 

Respectfully, 

Leonard Ryerson. 
Brooklyn, N. Y. 



NORTH CAROLINA. 

BELOW-KNEE AMPUTATION. 

December 7, 1891. 
To Mr. A. A. Marks, 701 Broadway, New York : 
My leg is working O. K. I have worn it every day since I put it on last 




No. 1226. 

April. I am runnning a locomotive every day. Would not have any other 
am often asked by my friends which of my legs is off. 

Yours most respectfully, 

W. J. Anguer. 
Craven County, N. C. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Swain County, N. C, Dec. 17, 1895. 
A. A. Marks : 

Dear Sir : — I have been wearing one of your legs since 1882. I am a 
miner by occupation, and have been rushing over the mountains of North 
Carolina. My leg was made by self-measurement. 

W. S. Thomas. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 475 

BELOW-ELBOW AMPUTATION. 

Fitted from Measurements. 

Rowan County, N. C, July 30, 1896. 
Mb. A. A. Marks ; 

Dear Sir : — I take pleasure in stating that the arm you made me goes far 
beyond my expectations. I am a farmer, forty -five years old ; I have worn one 
of your arms nine years without any cost for repairs, and it is in good order 
yet. 

Yours, etc, 

S. A. Kenerly. 



NORTH DAKOTA. 

ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Walsh County, N. Dak., Oct. 12, 1893. 
Mr. A. A. Marks : 

Dear Sir : — Your limbs are the best I have ever seen ; they are far ahead of 
the slip-socket limbs which are made in Minneapolis. I am so well satisfied 
with what I have that I will purchase a new limb from you soon. 

Yours truly, 

Henry Franklin. 



OHIO. 

BOTH LEGS AMPUTATED, ONE IN THE KNEE JOINT AND THE 
OTHER BELOW THE KNEE. 

Putnam County, O., Dec. 17, 1895. 
Mr. A. A. Marks, New York City, N. Y. : 

Dear Sir :— On the 12th of April, 1875, 1 had the misfortune to lose both my 
feet in a railroad accident. To-day I am fully convinced of the wisdom of 
my choice, in selecting you as my limb-maker, for I am walking far better 
than I or any of my friends thought I would ever do. 

Since one of my limbs was amputated at the knee joint, and the other an 
inch and one-half below, it was the general belief of myself and my friends 
that I could not handle myself well enough to walk with any degree of safety 
or satisfaction. 

I now walk wherever I want to go, and am filling a responsible position in 
a railroad office. 

You have already been informed that I am a member of the Knights of 
Pythias, and frequently parade on foot with my lodge ; this is a proof that I 
am well able to take my part in the battle of life. My weight is now two 
hundred pounds, but with this excessive weight I have little or no trouble in 
walking, even in extreme hot weather. I have lately become a member of the 
Accident Insurance Company, whose general agent assured me that they had 
nothing to fear from my inability to take care of myself. 

I remain, very truly yours, 

(Illustrated on pages 126-127). A. A. Weaver. 



ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 
Mr. A. A. Marks : 

Dear Sir : — I have been wearing your artificial legs for the last twenty-five 
years. I have been working on a farm most of the time ; I can plow and do 



476 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



all kinds of work. I am well pleased with the rubber foot. I can walk over 
rough ground with ease. I am working from sunrise to sunset most every- 
day. 

My leg was made by measurements and it fits me perfectly. The expense 
of keeping the leg in repair is very small, considering how rough I have 
used it. 

Yours truly, 

D. W. Pritcbard. 
Delaware County, O., Dec. 21, 1895. 



ABOVE-KNEE AMPUTATION. 

Muskingum County, O., Dec. 16, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I have worn artificial legs for thirty years, and think I ought 
to be a pretty good judge of them by this time. After wearing your artificial 
leg with patent rubber foot attached for over twenty years, it gives me great 
pleasure to recommend them to any person or persons wanting anything of 
this kind. 

Yours truly, 

Silas W. Fickel. 



ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Portage County, O., Dec. 16, 1895. 
Mr. A. A. Marks, New York City : 

Dear Sir :— The artificial leg which I received of you in October, 1885, with 
rubber foot is giving me perfect satisfaction in every respect. I have worn 
four different makes of legs inside of thirty years, with ankle joints, and can 
truly say that I would not have a new leg with the ankle joint as a gift, since 
I have been wearing your rubber foot. My occupation is a barber. Around 
town I hardly use a cane, except in winter time. 

Respectfully your friend, 

E. E. Rose. 



ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Trumbull County, O., Dec. 19, 1895. 
To Mr. A. A. Marks : 

My Dear Sir : — My opinion is based on actual observation and by compari- 
sons with legs of different patterns in walking over rough and icy surfaces as 
well as on the smooth floor. The Marks leg is by far the safest and easiest 
managed. 
I am a farmer fifty-eight years old. 

Yours very truly, 

Frank A. Clisby. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Ashtabula County, O., Dec. 17, 1895. 
A. A. Marks, Esq., New York City : 

Sir : — My left leg was amputated below the knee, and your substitute 
has been worn, to my great convenience and safety. I feel grateful that you 
have been so fortunate as to produce so exceedingly valuable and satisfactory 
a limb. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 477 



My occupation is painting, necessarily standing a great deal, ascending 
ladders, climbing buildings, etc. 
The limb has never failed to be all I required in my business. 
I am, respectfully, your obt. servant, 

William H. Leroux. 



ABOVE-KNEE AMPUTATION. 

Dec. 17, 1895. 
A. A. Marks, New York : 

Dear Sir : — I have been wearing the leg for nearly ten years, and can say 
that it gives perfect satisfaction. I had worn the wooden foot for eight years 
previous to this one of your make, and it is a great relief to be able to walk on 
the street without attracting the attention of everyone you meet. 

J. V. Merwin. 
Cleveland, O. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Richland County, 0., Dec. 17, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I have worn three limbs made in Philadelphia, but received 
scarcely any benefit from their use ; but when I got you to make one for me 
in June, 1880, I found I had hit the mark. I am still wearing your make, and 
to all appearance will continue to do so. My limb is amputated four inches 
below the knee. 

I am tilling the soil on a small scale, and am on my feet from morning until 
night, and feel no inconvenience from the use of your limb. The measure- 
ments I sent you secured a good fit, which shows that you can make as good 
a fit as if I had come to you, and you had taken the measure yourself. 

Wm. C. Creswell. 



BELOW-KNEE AMPUTATION, 

Seneca County, O., March 3, 1896. 
A. A. Marks*. 

Dear Sir : — The rubber foot you made me eleven years ago is perfectly 
satisfactory. Yours truly, 

H. B. Lawrence. 



BELOW-KNEE AMPUTATION. 

Cleveland, O., Nov. 5, 1887. 
A. A. Marks, Esq. , New York City : 

Dear Sir : — For the past twenty-six years I have used your limbs as a sub- 
stitute. Have found the same to answer the purpose about as nearly as art 
can approach nature. It has proved safe, reliable, and durable in all kinds of 
service, and under all circumstances, and with the exception of substituting 
a new socket once, when the old one had become too small, total cash for 
repairs has not equaled $1 per year. 

As I weigh about 190 pounds, and see considerable of active life, my impres- 
sion is that I have done the square thing by it, so far as testing its qualities is 
concerned. Yours truly, 

Jno. G. James. 



478 A. A. MAKKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



BELOW-KNEE AMPUTATION. 

Dec. 17, 1895. 
Mr. A. A. Marks : 

Dear Sir: — I Lave been wearing artificial legs for the period of nearly 
thirty years, the first fourteen of which I wore legs manufactured at 

Indianapolis, Ind. The next five years I wore out one of Dr. 's artificial 

legs made in N. Y. City, and the ten last years I have been wearing your artificial 
leg with the rubber foot. It gives good satisfaction. I think that the rubber 
foot is the best artificial foot that is made. 

Yours truly, 
Van Wert County, O. J. W. Huntzinger. 



BELOW-KNEE AMPUTATION. 



Dec. 23, 1895. 



Mr. A. A. Marks : 

Dear Sir : — I have worn your artificial leg for ten years, and I find it to be 
a good substitute for my natural leg. 

I can most emphatically say that it is the best I can get, and far superior to 
any I have ever seen for comfort and durability. 

Yours respectfully, 

Vinton County, O. C. H. Hayes. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Williams County, O., Dec. 16, 1895. 
A. A. Marks : 

Dear Sir : — I have been wearing your make of artificial limbs since 1868. 
Previous to that I had worn one of another make. I consider yours much the 
better. Its points of superiority are chiefly in the doing away with the loose 
togel joints found in ankle and toe.' Your rubber foot does away with the 
necessity for these joints, and gives the step a certainty of action that no other 
leg has. It also gives a springy, light step that is impossible in a wooden 
foot. Your knee joint irons are much better than those of the other leg I 
wore. I have had three of your legs, and one was fitted from measurements 
furnished by myself, and the others direct to person. The one made from 
measurements was as good as the others. My point of amputation is two and 
one-half inches below the knee. 

I am yours truly, 

Simeon Gillis. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Wood County, O., Dec. 17, 1895. 
A. A. Marks, New York : 

Dear Sir : — My leg was taken off seven inches below the knee. - 1 got an 
artificial one with rubber foot nine years ago last winter ; since then I have 
done the same work as I did before, and that is farmwork. I am twenty-six 
years old now, and can lift as much as anybody, and walk eight or ten miles 
without any trouble. Last winter I used the leg very hard while driving 
teams and hauling timber. 

Yours, etc., 

Franklin L. Rouse. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 4*79 

BELOW-ELBOW AMPUTATION. 

Fitted from Measurements. 

Mahoning County, O., Dec. 17, 1895. 
Me. A. A. Marks : 

Dear Sir : — I have worn one of your artificial arms for twenty-eight years. 
About sixteen years ago I changed the hand, which was somewhat worn, for a 
rubber one, simply sending measurements, as I did in the first place for the 
arm, and both arm and second hand were perfect fits. The rubber hand 
seems to be just as good, after sixteen years of use, as it was at first. 

My arm, the right one, is amputated midway between the wrist and elbow. 
During nearly thirty years that I have worn your artificial arm it has not cost 
me a cent for repairs, except the change of hand. 

Rev. Geo. Bosley. 



BELOW-ELBOW AMPUTATION. 

Fitted from Measurements. 

Dec. 16, 1895. 
Mr. A. A. Marks : 

Dear Sir :— I ordered an artificial hand from you some ten years back, and 
have been wearing it every day since. I have never spent a cent for repairs in 
the ten years I have been wearing it. I work at A. E. T. Works, laboring, 
and can do as much work as any of the men with two hands who work in 
the same room with me. My hand was amputated at the wrist joint, and your 
arm could not have fitted better if I had been right there and had it measured. 

Yours respectfully, 

Muskingum County, O. Clarence Uphold. 



BELOW-ELBOW AMPUTATION. 

Muskingum County, 0., Dec. 6, 1895. 
A. A. Marks : 

Dear Sir : — I have given my artificial hand a fair trial and I am more than 
pleased with it. I think there could be nothing better made. I feel that I 
can never say enough in way of praise of my hand. 

Very truly yours, 

Myrtle R. Hayes-Butler. 



OKLAHOMA TERRITORY. 

ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Kingfisher County, Okea., Nov. 30, 1895. 
Mr. A. A. Marks : 

Dear Sir :— I have worn one of your artificial legs for six years, and it has 
given perfect satisfaction. I would not go without it for any money, I seldom 
if ever use a cane, and when I do I generally go off and forget it. 

Yours truly, 

J. W. Grin. 



480 



A. A. MAEKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Woodward County, Okla., March 10, 1896. 
Mr. A. A. Marks: 

Dear Sir : — I have used artificial legs for over twenty-nine years, and I 
think I ought to be a good judge. I can walk easier with your leg and rubber 




No. 1227. 

foot attachment than with any other leg I have ever tried, and I have tried 
four different kinds. 

I am a plasterer by trade, and work with your leg on the scaffold every day 
now. It fits me better than any leg I have ever tried, and it was made from 
measurements. Veryitruly yours, 

James Dimmick. 



OREGON. 

ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Astoria, Ore. , March 9, 1893. 
A. A. Marks : 

Dear Sir : — I have the pleasure to inform you that I am well satisfied with 
the leg vou made for me ; it is the best leg I ever wore, and gives me the best 
satisfaction. I can walk with it splendidly. I am, 

Yours truly, 

L. I. Johnson. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



481 



ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Marion County, Ore., June 20, 1894. 
A. A. Marks : 

Most Esteemed Sir : — I have been for a long time desirous of writing you 
and expressing my continued satisfaction with the artificial leg you made for 




me, and now avail myself of the opportunity. It is five months since I 
obtained it. I walk very much and without a cane or support. I suffer no 
pain or uneasiness from it. My artificial leg is my best friend ; without it my 
life would be miserable. (Occupation, sawmill and logging.) 

W. R. Swtnk. 



BELOW-KNEE AMPUTATION. 
Fitted from Measurements. 



Portland, Ore., Oct. 14, 1895. 
A. A. Marks : 

Dear Sir :— Your leg is a gem, the best I ever had ; it is a perfect fit. and 
the only one that I ever had that I could put on and wear with ease. It fits 
me just like a nice fitting shoe. I remain, 

Yours truly, 

R. W. Pool. 



482 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

BELOW-ELBOW AMPUTATION. 

Fitted from Measurements. 

Douglas County, Ore., July 13, 1896. 
Mr. A. A. Marks : 

Dear Sir : — I received the artificial arm you sent to me in perfect order, 
and have been well pleased with it. I put it on the same day that I received it, 
and have worn it every day since. I could not do without it at all. I do all 
my own work, washing, ironing, patching, darning, almost all my sewing. 
We have three children, the oldest three years old last May, the youngest eight 
months old, and I have taken care of them myself. 

Very gratefully, 

Mrs. Thomas Nicholson. 



PENNSYLVANIA. 

BOTH LEGS AMPUTATED ABOVE THE KNEES. 

York County, Pa. , Dec. 15, 1895. 
A. A. Marks : 

Dear Sir : — After sixteen years' use of the pair of artificial limbs you made 
for me with the rubber feet, I must truly say that I think you make the best 
artificial limbs. I wear them every day, and have not lost one day from the 
time I got them on account of their getting out of order. My work is not hard 
on limbs, but I am on my feet the most of the time. As my case is a bad one, 
I think I am doing very well. 

Yours very respectfully, 

Robert S. Lovegrove. 



BOTH LEGS AMPUTATED BELOW THE KNEES. 

Lehigh County, Pa., Jan. 6, 1896. 
Mr. A. A. Marks : 

I will inform you that my brother-in-law George Miller is getting along very 
well. He is working now ten years for the Philadelphia and Reading Rail- 
road Co., as a watchman on a street-crossing at Macungie. He feels very 
proud with his legs, and is proud of them. 

Allen Christman. 



BOTH LEGS AMPUTATED BELOW KNEES. 

Luzerne County, Pa., Dec. 1895. 
Mr. Marks : 

Dear Sir : — I am wearing two of your patent artificial legs for the last 
twelve years. Only once have I had them repaired, with very little expenses, 
and I think I can use them for some time yet. 

J. Senghaas. 



BOTH LEGS AMPUTATED BELOW THE KNEES. 

Philadelphia County, Pa., Dec. 15, 1895. 
A. A. Marks, Esq.: 

Dear Sir : — I am very glad to testify to the comfort and durability of your 
artificial limbs. Mine have been worn since July, 1882, and, being perfectly 
adjusted, they have enabled me to walk easily and naturally. 

The ladies and gentlemen residing here have examined and commended your 
work. The Forest Home estate is extensive, and I walk with the same ease the 
country roads or streets of Philadelphia. 

Yours, 

Henry Laurens Bascomb. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 483 

BOTH LEGS AMPUTATED BELOW THE KNEES. 

Philadelphia, Dec. 27, 1895. 
A. A. Marks : 

Dear Sir : — I have worn my pair for fifteen years, and although my posi- 
tion requires a good deal of walking, I have never expended one penny to 
keep them in repair, while several of my companions who wear the old style 
are not only constantly at an expense for repairs, but are obliged to keep an 
extra one to wear. 

My right foot is off nine inches and my left six inches below the knee. With 
my weight, over two hundred pounds, I know there is no man of my acquaint- 
ance of anywhere near the same weight, with only one limb, who can get along 
nearly as satisfactorily as I do. 

Yours truly, 

Charles W. Glenn, Sr. 



BOTH FEET AMPUTATED, ONE CHOPART'S AND THE OTHER 
BELOW THE KNEE. 

Columbia County, Pa., Dec. 28, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I take pleasure in testifying to the satisfaction I have derived 
from the use of your artificial limbs. 

I believe your rubber feet are easier to walk upon, more durable, and much 
more natural than any other kind. I was eleven years of age when I had my 
leg and foot taken off, and it was a year and fourteen weeks before I could go 
on crutches, and I wore a peg leg about thirteen years. I have worn your 
rubber feet ever since and would not be without them. 

I remain, yours respectfully, 

George Unbewust. 



ABOVE-KNEE AMPUTATION. 

Aug. 3, 1896. 
A. A. Marks : 

Have been wearing artificial limbs forty-six years. I wore out six in 
twenty-two years, costing me from twenty-five to forty-five dollars a year to 
keep them in running order. Did not enjoy the rattling of them. Have been 
wearing a Marks leg twenty-four years ; expense one dollar a year, and all com- 
forts a veteran could wish for. My limb is in as good running order now as 
when I first commenced to wear it. I expect it to last many years. 

James T. Sample, Mexican Veteran. 

Allegheny County, Pa. 



ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Blair County, Pa., Dec. 4, 1895. 
Mr. A. A. Marks*. 

Dear Sir :— I received one of your patent artificial legs with rubber foot 
fitted from measurement some ten years ago, and from that time to the present 
writing I have worn it every day. 

I am a farmer, living in the country, and have rough roads to travel, but I 
can walk five miles a day. Yours truly, 

Miles Lewis. 



ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Erie County, Pa., Dec. 16, 1895. 
A. A. Marks : 

Dear Sir : — I am a telegraph operator, and live two miles from the office. I 
walk that distance every night and morning. I have worn one of your arti- 



484 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



ficial limbs for over ten years, and I can cheerfully say that I think it has no 
equal. 
My limb was made from self -measurements and is a perfect fit. 
It is just as good to-day as it ever was ; in fact, there is nothing that I can 
see to wear out. My limb was amputated about six inches from the body. 

Very respectfully yours, 

Frank A. Porter. 



ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Dauphin County, Pa., Dec. 11, 1895. 
A. A. Marks : 

- Dear Sir : — I have a stump ten inches long. I have worn a leg seventeen 
years. I have walked as far as twenty miles in one day, and did not mind it 
as much as one of the men with me, for he had to go to bed, and he had two 
good legs. 

I am a janitor of a school building now. The building has twelve rooms, 
and I fire six furnaces. 

Respectfully yours, 

J. F. SOURBEER. 



ABOVE KNEE AMPUTATION. 

Fitted from Measurements. 

Dauphin County, Pa, Dec. 18, 1895. 
Dear Sir : — The artificial leg I received from you in 1886 when at Lititz 
has satisfied me fully. I had little confidence in artificial legs, as my stump 
had been out of use for four years and had become weak and stiff. I never 
use a cane, and travel long distances. In regard to the rubber foot, I am so 
attached to it I would not consent to wear any other ; its movements are all I 
can ask for. Respectfully, 

Wm. F. Duncan. 



ABOVE-KNEE AMPUTATION. 

Northampton County, Pa., Jan. 15, 1896. 
A. A. Marks : 

N Dear Sir : — Almost ten years have passed by and still I am contented with 
your leg. No noise, no breakdowns, no discomforts of any kind : all is quiet, 
durable, and satisfactory. Sincerely yours, 

Erwin P. Miller. 



ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Wyoming County, Pa., Aug. 13, 1895. 
Mr. A. A. Marks: 

Dear Sir : — The artificial leg I received from you in 1893 has been in use 
since I received it. I am doing all kinds of work, and find the leg reliable in 
every respect. Although I am working in a telegraph office at the present 
time, I am general freight and baggage clerk for the Lehigh Valley R. R. 
This work requires me to be on my feet a good share of the day. I handle 
freight of all kinds and weights, often have to pick up a heavy valise in each 
hand, and carry them quite a distance. I do not use any cane at all. 

My stump is* only five inches from the body. Most persons wonder how I 
get along so well, indeed hardly anyone wtfuld think that I had a leg off at all. 

Yours truly, 

S. L. Gardner. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 485 



KNEE-JOINT AMPUTATION. 

Dec. 16, 1895. 
Dear Sir : — I have been wearing your make of artificial limb with rubber 
foot for about seventeen years, and I must say that I consider them the best 
that are made for durability, elegance, fit, and movements. I can do all my 
work as well as though I had my own natural limb. 

Mrs. Ella E. Miller. 
Philadelphia, Pa. 



BELOW-KNEE AMPUTATION. 

Berks County, Pa., Dec. 19, 1895. 
A. A. Marks, New York City : 

Dear Sir : — I have the greatest pleasure in addressing you these few lines, 
in order to express the satisfaction I have with the artificial leg you manufac- 
tured for me. To the comfort and stability of your artificial leg I owe the 
invaluable treasure of walking almost naturally. I never use a cane. My 
occupation is laborious. I have used your make of legs since 1866. I have 
used this one sixteen years, and it has proved most satisfactory, never having 
required any repairs. I claim to be capable of judging of its merits. 
I remain, your obedient servant, 

G. W. Reider. 



BELOW-KNEE AMPUTATION. 

Carbon County, Pa., Dec. 16, 1895. 
A. A. Marks, New York City : 

Dear Sir : — My artificial limb is all that can be expected. Indeed a great 
deal more than I had a right to expect. My friends all say that anyone not 
knowing me could not tell that I am wearing an artificial leg. 

Very truly yours, 

A. W. Raudenbush. 



BELOW-KNEE AMPUTATION. 

Carbon County, Pa., Dec. 16, 1895. 
Mr. A. A. Marks: 

Dear Sir: — I am more than pleased with the leg I purchased of you. I 
can get along very well— so well in fact strangers will not believe me when I 
tell them I have an artificial leg. I am a member of the brass band of our 
place, and can travel with any of them. My occupation is a laborer in the car- 
shops of this place. 

Yours sincerely, 

Wm. C. Nuss. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Crawford County, Pa., Dec. 20, 1895. 
A. A. Marks : 
Dear Sir:— My leg is entirely satisfactory. 

My occupation is running a planing mill, which is laborious and heavy on 
the limbs and feet, handling lumber most of the time. 

My weight is over two hundred pounds. The rubber foot prevents any jar 
and makes the tread light and elastic. 

Yours respectfully, 

W. W. White. 



486 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Dec. 16, 1895. 
Mr. A. A. Marks: 

i Dear Sir :— I have used your artificial limb for thirteen years, and find it 
gives perfect satisfaction in every respect. My right leg was amputated about 
four inches below the knee. When I received the limb I was agreeably sur- 
prised at the perfect fitting by self-measurement. I am a shoemaker by 
trade. 

Frank P. Newmyer. 
Fayette County, Pa. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Fayette County, Pa., Dec. 16, 1895. 
Mr. A. A. Marks : 

Dear Sir : — Am now wearing the second artificial leg manufactured by 
you. I take pleasure in bearing testimony to merit, etc. 

Yours truly, 

T. Robb. Deyarmon. 



BELOW-KNEE AMPUTATION. 

Dec. 16, 1895. 
To A. A. Marks, New York : 

Dear Sir : — For a long time I have been wanting to write to you and let 
you know the perfect satisfaction your artificial leg has given me. I am 
able to skate, run, dance, and, what. gives me the most satisfaction, I am 
able to ride a bicycle ; not only ride it, but have been able to keep up witli 
very good riders, and have ridden fifty miles at a time. 



Lebanon County, Pa. 



J. A. Frantz. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Lackawanna County, Pa., Dec. 24, 1895. 
Mr. A. A. Marks: 

Dear Sir : — In 1866 I bought one of your artificial legs with rubber foot, 
and wore it for fourteen years without one dollar for repairs. In 1880 I 
ordered another one of your legs, and have worn it continuously ever since 
without one dollar expense. 

By occupation I am a barber, and have worked at the chair for the last 
eighteen years. ' Yours truly, 

G. H. White. 



BELOW-KNEE AMPUTATION. 

Lackawanna County, Pa., Dec. 16, 1895. 
A. A. Marks, Esq. : 

Dear Sir :— On September 30, 1876, I lost my left leg. At that time I 
weighed 182 pounds. After getting well my weight increased to 208 pounds. 
I thought then that I was too heavy to wear an artificial limb, until I came 
across a gentleman who was a much heavier man than myself, who had worn 
one Of your artificial legs with rubber foot for. over ten years. "This being a 
very good recommend from an entire stranger, I came to the conclusion that I 
would have one made also. 

I got one in 1881, and have now worn it fourteen years. . . \ : 

I would further state that I am well pleased with it. 

John H. Wilson. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK ClTT. 487 



BELOW-KNEE AMPUTATION. 

Lackawanna County, Pa., Dec. 19, 1895. 
Mr. A. A. Marks: 

Dear Sir :— Having for the past twenty-eight years been your customer 
I desire to add my testimony. I wore one of your feet every day for fourteen 
years, with but one dollar's expense for repairs. None but those who know of 
my having lost a limb will believe that I wear a patent leg, so naturally and 
easily do I walk. I never use a cane, and make no rattling noise when I walk 
on the sidewalk. 

I worked for six weeks in a furniture manufactory with twenty men ten 
hours a day, and not one of them knew I had lost a limb until I told them. I 
am a cabinet maker and undertaker by trade. I am on my feet all the time. 

J. W. Mershon. 



BELOW-KNEE AMPUTATION. 

Luzerne County, Pa., Dec. 16, 1895. 
Mr. A. A. Marks, New York : 

Dear Sir : — I have been wearing one of your legs for fifteen years, and in 
that time have never lost a day's work. 

My occupation is shipping clerk for a sash and door factory. It is a three- 
story building, and my business calls me up and down the stairs a great many 
times a day. I can go up or down a pair of stairs as fast as anyone that has both 
legs. In my estimation there is no limb made in the wide world that will give 
the wearer the satisfaction that yours will. I have tried some other makes 
with the joints in the ankle, but they are useless to me. 

Yours truly, 

G. E. Carpenter. 



BELOW-KNEE AMPUTATION. 

Dec. 17, 1895. 
A. A. Marks : 

Dear Sir : — I lost my left leg eight inches below the knee in the late war. 
In 1870 I procured one of your limbs with a rubber foot, which I wore with 
ease and comfort for five years. In 1875 I received the second limb with the 
rubber foot. 

I walk so perfectly that anyone who is not acquainted with my misfortune 
cannot detect that I am a wearer of an artificial limb. I am a tinner, and for 
the last eighteen years I have been engaged constantly in putting on tin and 
iron roofs, and will defy any man with good sound limbs to beat me climbing 
a ladder or getting over the roof of a building, regardless of pitch. Having 
worn your limbs constantly since 1870, I know whereof I speak when I say 
that your limbs with the rubber feet are the best. 

I remain, yours truly, 

Mercer County, Pa. E. F. Bennett. 



BELOW-KNEE AMPUTATION. 

Mifflin County, Pa., Dec. 16, 1895. 
A. A. Marks : 

Dear Sir : — I take much pleasure in stating that the artificial leg I bought 
of you nine years ago has given entire satisfaction. 

Yours respectfully, 

F. J. Zerbe. 



BELOW-KNEE AMPUTATION. 

Northampton County, Pa., Dec. 16, 1895. 
Dear Sir : — I have worn your artificial leg nine years and I have had full 
satisfaction. I can say for truth that the rubber foot cannot be excelled in the 



488 A. A. MABKS, AETIFICIAL LIMBS, NEW YORK CITY. 



world. I can say for a perfect fit, and ease and comfort in wearing, it is the 
greatest invention I know of . I have a half a mile to go to work. I weigh all 
the stuff the company buys and sells, so I am all the time on my feet, and I 
can walk as good as ever I did. 

I remain, yours truly, 

Michael Fox. 



BELOW-KNEE AMPUTATION. 

Northampton County, Pa., Jan. 8, 1896. 
I have worn an artificial leg with rubber foot for thirty-one consecutive 
years. The repairs during that time have been slight. 

I have been thoroughly satisfied with the action of the leg and cheerfully 
recommend it to all. 

John H. Mebus. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

March 4, 1895. 
A. A. Marks : 
Dear Sir : — I would say your leg has been very satisfactory to me. 
I am a hatter by trade : I have considerable walking to do, and sometimes 
heavy lifting, and out of five different makes of artificial legs which I have 
used, I find yours to be the most durable, combined with ease and comfort. 
My point of amputation is below the knee. Your success in fitting me from 
measurements has been very satisfactory indeed. Used your make of limb 
thirteen years. 

I remain, yours respectfully, 

Wm. Williams. 
Philadelphia, Pa. 



BELOW-KNEE AMPUTATION. 

Bee. 14, 1895. 
s Mr. Marks : — I have worn artificial limbs for the past seventeen years ; some 
have been of other make, and I can testify that yours is decidedly the best for 
comfort and ease, and does not make that rattling noise when walking, or that 
ugly sound on the pavement, as other limbs do. As to fitting, I do say that 
mine fits as well as I could expect. I am a dressmaker by occupation." My 
amputation is seven inches below the joint ; I have a great deal more comfort 
from your limbs than from the others. Your limb is all and everything that 
a person can expect. 
I have been wearing it twelve years without any repairs. 

Yours respectfully, 

Miss M. A. Cabr. 
Philadelphia, Pa. 



BELOW-KNEE AMPUTATION. 

Schuylkill County, Pa., Jan. 22, 1896. 
Mr. A. A. Marks, Esq.: 

Dear Sir : — My right leg is amputated seven inches below the knee. In 
August, 1886, you made me an artificial leg which gives entire satisfaction, 
and has proved a great friend to me since. The ' ' rubber foot " gives the leg 
its advantage over others. 

I canvassed for books, etc., from April to August, walking twenty miles or 
more a day, and did not feel any more fatigue than I would if I had my two 
sound legs. 

Yours very respectfully, 

Geo. W. Kutch. 



A. A. MAEKS, ARTIFICIAL LIMBS, NEW YORK CITT. 489 

BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Schuylkill County, Pa., Dec. 16, 1895. 
A. A. Marks, Esq. : 

Dear Sir : — The leg I purchased of you twelve years ago is giving me 
entire satisfaction. It is almost as good to-day as when I bought it. 

It has not cost me one dollar for repairs, although it has been subjected to a 
very severe test. I am an engineer, consequently on my feet nearly all day 
long. 

Yours very respectfully, 

Jos. Hinks. 



BELOW-KNEE AMPUTATION. 

Wayne County, Pa., Dec. 17, 1895. 
,Mr. A. A. Marks: 

Dear Sir : — I have worn your artificial legs twenty-two years. 
I handled, one afternoon, one hundred and sixty barrels of apples, which 
would be a fair half -day's work for a sound man. 

Yours truly, 
^^ C. A. Cortright. 

BELOW-KNEE AMPUTATION. 

York County, Pa., Dec. 15, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I have been using an artificial leg of your make for eleven 
years. I am a tinner by trade. I can climb ladders and work at tin roofing. 

The leg fits me to perfection, and the first time I put it on I walked without 
a cane, and do not use a cane now. I consider the rubber foot superior to any 
other, as there is no ankle joint to get out of order. I want none but your 
manufacture. * 

Gratefully yours, 

Jacob W. Selak. 



ANKLE-JOINT AMPUTATION. 

Dec. 16, 1895. 
Mr. A. A. Marks : 

Dear Sir : — The aluminum artificial leg you made for me gives good satis- 
faction. It is made very strong, neat, and light. I can walk so easy that the 
people do not know whether I have an artificial or natural limb. 

Yours respectfully, 
Allentown, Pa. Steward J. Metzger. 

ANKLE-JOINT AMPUTATION. 

Mercer County, Pa., Dec, 1895. 
Dear Sir : — I am now attending gate on N. Y., P. & O. R. R., and the foot 
you made forme is doing my work first class, and is giving excellent satisfaction. 

Very truly, 
t ___ Jno - Welch. 

INSTEP AMPUTATION. 

Harrisburg, Pa., Dec. 14, 1895. 
A. A. Marks : 

Dear Sir :— I am glad to testify that your appliance for my foot, a Chopart's 
amputation, is the finest article in the market. I am a fireman on the P. R. 
Road and do my work thoroughly. 

I am, very respectfully yours, 

C. P. Hutchinson. 



490 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

ABOVE-ELBOW AMPUTATION. 
Fitted from Measurements. 

Centre County, Pa., Dec. 16, 1895. 
Mr. A. A. Marks : 
Dear Sir :— I hare used an artificial arm made by you for fifteen years. 
There was no difficulty in obtaining correct size from your system of 
measurements. My arm is off halfway between elbow and shoulder. 

Yours truly, 

Rev. S. H. Eisenberg. 



ABOVE-ELBOW AMPUTATION. 

Fitted from Measurements. 

Monroe County, Pa. , Dec. 19, 1895. 
Mr. A. A. Marks . 

Dear Sir : — I am wearing one of your patent arms, and can say that they are 
very strongly made and very durable. 

My arm was amputated close to the shoulder, with scarcely stump enough 
for use. I am satisfied with the rubber hand. 

Respectfully yours, 

S. Bush. 



BELOW-ELBOW AMPUTATION. 

Northampton County, Pa., Dec. 16, 1895. 
A. A. Marks, Esq.: 

Dear Sir : — I can recommend your artificial arms. Mine gives me great 
satisfaction. I have seen many other arms, but none of them are equal to the 
one you have made for me. 

I have the arm thirteen years, and the arm is good for some time to ceme. 
I would not do without it under any consideration. My amputation is between 
the wrist and elbow. I am working in the office of the L. V. R. R. Co., and 
my artificial arm comes in very good in holding and folding all kinds of paper, 
which is required in my profession. 

I am, yours truly, 

John A. Seibel. 



BELOW-ELBOW AMPUTATION. 

Washington County, Pa., April 4, 1896. 
Mr. A. A. Marks : 

Dear Sir : — I have tried four or five of the leading manufacturers' patents 
of artificial arms. 

There are none that I have tried that gives me the satisfaction that yours 
have. All of these clap-trap, cat-gut arrangements will get out of order in a 
very short time. 

Yours very truly, 

Isaac Vance. 



WRIST AMPUTATION. 

Dec. 19, 1895. 
A. A. Marks, Esq., New York. 

Dear Sir : — It gives me great pleasure to say that I am wearing one of your 
patent arms. I feed a planing machine, handling from eighty to one 
hundred feet of heavy yellow pine lumber in one minute without any incon- 
venience. 

Respectfully yours, 
Philadelphia, Pa. Joseph Sheridan. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 491 

RHODE ISLAND. 

ABOVE-KNEE AMPUTATION. 

Newport, R. I., Sept. 30, 1895. 
A. A. Marks : 

Dear Sir :— I take pleasure in saying that Chas. White received his artificial 
leg a short time ago. He is pleased with it and has reason to be, for it is an 
excellent piece of workmanship. 

Respectfully yours, 

Chas. A. Gillen. 



ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Washington County, R. I., Aug. 11, 1895. 
A. A. Marks : 

Dear Sir : — I cannot say enough in praise of the artificial leg you made for 
me, I am so well pleased with it. I can get along with it first rate. I have no 
need of using a cane. 

Yours, - 

George B. Sherman. 



A. A. Marks, Esq. 
:— I do 



ABOVE-KNEE AMPUTATION. 

Washington County, R. I., Dec. 26, 1895. 



Dear Sir : — I do not see why anyone needs a testimonial to convince them 
that your legs are the best, when they need only to consider their construction 
to be convinced that is so. 

Yours respectfully, 

O. S. Chapman. 



BELOW-KNEE AMPUTATION. 

Dec. 18, 1895. 
Dear Sir : — I have worn the artificial leg that I purchased of you in 1887, 
every day since, and I am glad to tell you that I am very much pleased with 
it in every way. Why, it actually surprises some of my friends to see the way 
that I get around with it without the use of a cane. I tell you that you don't 
want a cane at all. I don't want one. It is in the way. 

Yours truly, 
Providence County, R. I. H. C. Mo wry. 



BELOW KNEE AMPUTATION. 

Dec. 17, 1895. 
Dear Sir : — I wore three artificial limbs before I received yours. 
Yours is the finest leg I ever wore for fitting and easy walking. 
The rubber foot is the best I ever used. 

My leg is off four inches below the knee and my weight is 216 pounds. I 
wore your first leg for over five years, and am now wearing the second one. and 
the first is good yet. I am janitor, and I have a great deal of walking to do. 

Respectfully yours, 
Providence, R. I. John Reynolds. 



492 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



PARTIAL-FOOT AMPUTATION. 

Dec. 16, 1895. 
A. A. Marks: 

I take great pleasure in recommending your aluminum artificial legs for in- 
step amputations, for they are neat, light, and serviceable, and they far exceed 
the wooden ones formerly used. My occupation is that of a warp twister in 
cotton mill. 

Respectfully yours, 

Providence County, R. I. John Howarth. 



SOUTH CAROLINA. 

ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Charleston, S. C, Dec. 17, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I have much pleasure in stating that the artificial leg L bought 
from you over twelve years ago has given me entire satisfaction. I have never 
lost an hour since I put your leg on. I never use a cane unless going a long 
distance from home. 

Yours truly, 

Sebastian Monserrat. 



ABOVE KNEE AMPUTATION. 

Fitted from Measurements. 

Spartanburg County, S. C, Aug. 3, 1894. 
A. A. Marks, New York. 

Dear Sib :— My artificial limb, I must say, fits the best of any artificial leg 
that I have ever had. I am, 

Respectfully yours, 

S. S. Bearden. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Richland County, S. C, Dec. 7, 1894. 
A. A. Marks, Esq. : 

Dear Sir : — I really don't know whether to flatter myself or you ; of course 
all belongs to you. t Our legislature is now in session, and among them are many 
one-leged Confederate veterans (I am one myself) ; some of them are wearing 
artificial legs which make a great deal of noise when they walk, while I go 
along silently and serenely, with-my hands in my pockets. I am, 

Very respectfully, 

John Gray. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Charleston, S. C, June 25, 1896. 
A. A. Marks : 

Deab Sib : — After wearing the artificial leg made by you for eighteen 
months I find it has proven in every way a success and is very satisfactory. 
I am, 

Your obedient servant, 

John Venning. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



493 



BELOW-ELBOW AMPUTATION. 

Fitted from Measurements. 

Hampton County, S. C, Aug. 10, 1892. 
Mr. A. A. Marks : 

Dear Sir : — I am well pleased with my artificial hand ; it is a great success. 
I am glad to say that I have not been without it during the day since it was 
received. It gives me no trouble at all, and is of great assistance in my work. 
I am, As ever, 

H. F. Bass. 



SOUTH DAKOTA. 

BOTH LEGS AMPUTATED BELOW KNEES. 

Fitted from Measurements. 

Beadle County, S. Dak., April 14, 1894. 
A. A. Marks : 

I am very much pleased with my feet ; I walk first rate with them. Last 
week I walked from Huron out to my farm, a distance of thirteen miles, and 



-A.^.' 




my feet never felt easier than when I got to the end of my journey. (Partial 
amputation of both feet.) 

' Geo. Risdon. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Hughes County, S. Dak., March 12, 1894. 
A. A. Marks, New York City : 

Dear Sir: — I am pleased to record that after having successfully used your 
leg I find it far superior to any of my former limbs, the natural one only 



494 



A. A. MAEKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



excepted. I lay no claim to discovering your principle of limbs without ankle 
joints, but, for the last fifteen years, I so modified the limbs that the ankle had 
hardly any play. With the same effort I formerly made I can now walk 
much further ; this I attribute to the rubber foot, and as for grace, bless your 
heart, there is no grace in any of them except yours. I walk strong and sure 
without assistance, fatigue, and that suits me. 

You may tell the " boys" for me that if they would be healthy, wealthy, 
and wise, to get a rubber foot, that nothing so reconciles one for the loss of a 
limb or two as your rubber feet, ankleless artificial limbs. 

Yours truly, 

John Sutherland. 



BELOW-KKEE AMPUTATION. 

Fitted from Measurements. 

United States Indian Service, Pine Ridge Agency, 
Shannon, S. Dak., Dec. 19, 1895. 
Mr. A. A. Marks : 

Dear Sir : — On September 18, 1889, 1 performed the operation of amputation 
of the left leg on Ceca Yamni (Peter Three Thighs), a Sioux Indian attached 
to this agency. He was a sufferer from necrosis of the tarsus, and a complete 




invalid, absolutely unable to stand. I did not succeed in getting his consent 
to operate until I told him about your excellent limbs, how he would be en- 
abled to walk, run, ride, work, etc. In due time the stump healed, and I sent 
you measurements for his leg. It came by express, and I immediately ad- 
justed it. To my surprise it fitted him perfectly, and at this writing he is 
going about among the Indians with as much ease and comfort as could be 
desired. Inclosed is a photograph in war costume, which he sends you with 



A. A. MARKS, AKTIFICIAL LIMBS, NEW TOEK CITY. 495 



his compliments, with a hope that it will be interesting to his race, and an 
example of what the ' ' White Medicine Men " can do for his people. 

Very respectfully, 

Z. T. Daniel, M. D., 
Agency Physician, U, S. Indian Service. 



ANKLE-JOINT AMPUTATION. BOTH FEET. 

Fitted from Measurements. 

Custer County, S. Dak., Dec. 17, 1895. 
Sir : — I have worn your artificial feet for ten years, and they have proved to 
be satisfactory. Could not do without them. I can do all kinds of farm work 
and get around naturally. Without your feet I could do nothing. 

Yours respectfully, 

Friend W. Meeker. 



TENNESSEE. 



BOTH LEGS AMPUTATED ; ONE KNEE BEARING, THE OTHER 
BELOW THE KNEE. 

Fitted from Measurements. 

Shelby County, Tenn., Dec. 21, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I have been wearing a pair of your artificial limbs with rubber 
feet ever since 1884 ; they were made by measurements, and give full satisfac- 
tion in every respect. I am flagging for the M. & C. R. R., at Union Street 
crossing, and have not lost a day on account of my limbs, and have not had 
any repairing done to them since I got them. I get around so spry and fast 
that people don't want to believe that I wear artificial limbs : I can go up or 
down stairs, three stories, get on and off trains, go anywhere I want, and 
need no help. Yours truly, 

J. E. Patterson. 



ABOVE-KNEE AMPUTATION. 

Maury County, Tenn., Dec. 19, 1895. 
A. A. Marks, New York City : 

Dear Sir : — For over nineteen years I have worn continually an artificial 
limb of your make. I can cheerfully say that it has given perfect satisfaction. 
I am a dentist ; my stump is but five inches long. I can stand at my dental 
chair and operate six hours a day with comparative ease. 

Yours respectfully, 

Dr. Robert F. Taggart. 



ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Washington County, Tenn., Dec. 18, 1895. 
Mr. A. A. Marks : 

Dear Sir: — I lost my foot by a mowing machine over fifteen years ago. 
My foot was amputated three inches above the ankle. I was induced to get 
one of your limbs with a rubber foot, which I did, and am wearing it yet. 
which has been about fourteen years. 

It has cost me about two dollars for repairs. I ordered it from your meas- 
urement blank, and it was a per fo ct tit. 

I am, yours truly, 

J. E. Crawford. 



496 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



BELOW-KNEE AMPUTATION. 

Jan. 24, 1896. 
Mr. A. A. Marks : 

Dear Sir : I will always feel thankful to you for your skill in fitting the 
artificial leg to me. I lost my right leg at the battle of Nashville, December 
15, 1864. It would have amused you to see me back home among my people, 
to see them eyeing me with curiosity, wondering how my right leg should have 
grown out so suddenly with a foot on it. They were not aware that I had 
gone to New York to have you fit such to me. 

Yours, with great respect, 

Carroll Childers, 

Nashville, Tenn. 



BELOW-KNEE AMPUTATION. 

Anderson County, Tenn., Dec. 6, 1887. 
Mr. A. A. Marks : 

Dear Sir : — I want to say to you that I am well pleased with the artificial 
leg furnished by you. 

I consider your rubber feet and hands the best yet invented. I received a 
leg from you two years ago, fitted from measurements sent to you. I have used 




v—^ 

i-^7?. 



No. 1231. 



your leg at nearly all kinds of work, such as plowing, spading, hauling logs, 
and other hard work. I have walked twenty-five miles in a single day. The 
rubber foot lasts longer and takes less repairs than anything I know about. 
Yours respectfully, 

Lewis C. Cox. 



BELOW-ELBOW AMPUTATION. 

Fitted from Measurements. 

Bedford County, Tenn., Jan. 5, 1896. 
Mr. A. A. Marks : 

Dear Sir :— After twelve years of constant use in wearing your patent arti- 
ficial arm with improved rubber hand, I am prepared to give testimony as to 
its merits. It has never cost a cent for repairs. As to usefulness, it equals my 
anticipation. 

Regards, etc., 

Geo. E. Waite. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 497 

TEXAS. 

BOTH LEGS AMPUTATED BELOW THE KNEES. 

Fitted from Measurements. 

Houston, Tex., Jan. 5, 1896. 
Mr. A. A. Marks : 

Dear Sir : — I received the limbs on the first of February, 1886, and put 
them on, and can say that my health is better, and I can walk anywhere I 
want to, night or day. I can go upstairs any height I want to. 

I can walk three miles per hour ; they never hurt me. I am a laborer, and 
my work is quite hard. Ben. J. Nickerson. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Austin, Tex., Dec. 28, 1895. 
A. A. Marks : 

Dear Sir : — The artificial leg you made for me some time ago fits nicely, 
and I am well pleased with it. v 

I am attending to business every day from morning till late at night without 
the assistance of a cane, and am able to do some tolerably heavy lifting and 
carrying. Yours respectfully, 

George Martens. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Austin, Tex., Dec. 18, 1895. 
A. A. Marks, New York : 

Dear Sir: — I am using one of your legs with rubber foot, and like it 
better than the old style. I have used artificial limbs for twenty-three years. 
My limb is off about halfway from ankle to knee. 

Kespectfully, 

A. R. Gossard. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Dallas, Tex., Dec. 17, 1895. 
Mr. A. A. Marks : 

Dear Sir :— I have been using one of your patent legs since 1871 ; it has 

never given me any trouble ; I can walk with an ease that is surprising: to 

myself. The india-rubber foot is, in my opinion, the next thing to life itself. 

I have used other artificial legs that had ankle joints, heel-cords, etc., that 

were clacking, breaking, and making a very obnoxious noise. 

Yours very truly, 

B. T. Humphreys. 



BELOW-KNEE AMPUTATION. 

Galveston, Tex., Dec. 19, 1896. 
Mr. A. A. Marks : 

My Dear Sir :— I lost my foot by the C, C. & S. Fe R, R., over three years 
ago. My foot was amputated four inches above the ankle. I was induced to 
get one of your artificial limbs with rubber foot, which I did. and am very 
much pleased with it. It was fitted from measurements. I am able to do 
almost anything on it. Yours truly, 

A. A. Titze. 



498 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Llano County, Tex., Dec. 19, 1895. 
Dear Sir : — I have been wearing your patent artificial leg for over fifteen 
years with the utmost satisfaction. I can go anywhere I want to. I can run, 
jump, and climb. Yours truly, 

W. E. Simpson. 



BELOW-KNEE AMPUTATION. 

Travis County, Tex., Dec. 15, 1895. 
A. A. Marks : 

Dear Sir : — I received one of your legs made from measurements Novem- 
ber, 1888, and it has proved to be a first class leg in every respect. I am a 
clerk in a hardware store and am on my feet all day. I go about without a 
cane and do some heavy lifting. 

Your respectfully, 

H. A. ZlMPELMAN. 



UTAH. 

ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Millard County, Utah, June 29, 1894. 
A. A. Marks : 

Dear Sir : — Two years ago I put on one of your artificial limbs. I can 
truthfully say it has been a great help to me, and I am confident that there 




are none better. I get along without any other assistance, and am able to 
attend to an acre and one half of garden. In fact, to make a long story short, 
everything is as you said it would be, and I am satisfied. 

Gratefully, 

David Day. 



A. A. MAEKS, ARTIFICIAL LIMBS, NEW YOEK CITY. 499 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Weber County, Utah, Dec. 19, 1895. 
A. A. Marks : 

Dear Sir :— I have used one of your artificial legs for over eleven years. 
The rubber foot works almost as well as the natural one, and after I got used 
to it I was surprised how easy it was to get along with my usual work on the 
farm. 

Yours respectfully, 

Timothy O'Neil. 



VERMONT. 



ABOVE-KNEE AMPUTATION. 

Franklin County, Vt. , Dec. 17, 1895. 
A. A. Marks : 

Dear Sir : — During the past fourteen years I have worn two artificial legs. 
The point of amputation is about halfway between the knee and hip, and 
although my occupation is very laborious, yet I experience very little incon- 
venience, owing to the perfect fit you gave me, and excellent manner in which 
the leg works, especially the rubber foot. 

Gratefully yours, 

Charles Lucia. 



BELOW-KNEE AMPUTATION. 



Dec. 17, 1895. 



Mr. Marks: 

Dear Sir : — From my twenty-one years of constant labor on your patent 

limb on a farm, I can truly say your leg is the best. I had one of 's 

before I got yours, and it did well for a year. It was the old style leg with 
ankle joint. It was out of repair very often, and it got so I did not dare to go 
out on the street with it. 

Yours truly, 

Burlington, Vt. Wm. B. Gill. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Caledonia County, Vt., Dec. 19, 1895. 
Mr. Marks: 

Dear Sir : — The artificial leg you fitted from my measurements fits me 
perfectly. I walked off with it from the start, and have had no trouble with it 
since. If anyone has a leg taken off that I know of, I shall certainly send 
them to you. 

Yours truly, 

C. H. Bolles. 



BELOW-KNEE AMPUTATION. 

Lamoille County, Vt., Dec. 16, 1895. 
A. A. Marks, Esq., New York City : 

Dear Sir : — I have worn your artificial limbs for twenty-two years, and 
during that time I did not have to pay out anything for repairs. 

My business for four years was farming, doing all kinds of work. Two 
winters I worked on the mountain cutting and skidding logs, which was a 
very trying test for the limb. 
I can walk five or six miles without any trouble. 

Yours very truly, 

* Edwin A. Gallup. 



500 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITT. 



BELOW-KNEE AMPUTATION. 

Orange County, Vt., Dec. 17, 1895. 
Mr. A. A. Marks : 

Dear Sir : — Before wearing your artificial leg I wore two with ankle and 
toe joints, cords, and springs. They were constantly out of repair. Have 
worn yours with rubber foot twenty years. My leg is amputated four inches 
below the knee. 

Respectfully yours, 

Leonard H. Goodrich. 



ABOVE-ELBOW AMPUTATION. 

Franklin County, Vt., Dec. 18, 1895. 
Dear Friend Mr. Marks : 

I lost my arm by the cars when I was very young, and I have only five or 
six inches of the arm left from the shoulder. The arm I purchased of you 
is very satisfactory. 

I can carry a heavy satchel, and I can do many things that make the arm 
worth many times the cost of it. I have had my arm over nine years, and it 
has never hurt me or bothered me. I am a telegraph operator in the train 
despatcher's office. 

As everyone knows that operators have to write very rapid, I do not know 
what I would do if it was not for the hand. I cannot half testify to the 
merits and comfort and pleasure I have taken in your arm. 

Yours very truly, 

Homer McGreggs. 



BELOW-ELBOW AMPUTATION. 

Fitted from Measurements. 
A. A. Marks : 

Dear Sir ■ — When quite a young boy I lost my right hand. I have had 
several artificial ones, but nothing which suited me as well as the one made by 
you. My hand was made by sending you my measures and a kid glove. 

I can truly say it has given perfect satisfaction. Is is just what you recom- 
mended it to be. I have recommended your work to others. 

P. S. Cunningham. 
Franklin County, Vt., Dec. 16, 1895. 



VIRGINIA. 

ABOVE-KNEE AMPUTATION. 

Dec. 6, 1895. 
A. A. Marks : 

Dear Sir : — I would like to accentuate all I have said about your goods. 
The elapse of a good many years confirms my belief that yours are the best 
I know anything about. I have lately seen those on our streets who have for 
years used your artificial legs, and no one would ever suppose they were walk- 
ing on anything but natural limbs. 

E. A. Craightll, 
Lynchburg, Va. 



ABOVE-KNEE AMPUTATION. 

Norfolk County, Va., Dec. 17, 1895. 
A. A. Marks : 

My Dear Sir : — I only have four inches of stump. Money can't buy this 
limb if I could not get another. I cannot say enough for the limb you made 
for me. 
Occupation, farmer. 

John F. Dozier. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITT. 501 



BELOW-ELBOW AMPUTATION. 

Fitted from Measurements. 

Augusta County, Va., Dec. 16, 1895. 
A. A. Marks : 

Dear Sir : — This is to certify that I have been wearing an artificial arm for 
eighteen years ; have been wearing one of your improved rubber hands for 
nearly ten years. It has given entire satisfaction both in wear and comfort. 
I consider it one of the best artificial limbs I have even seen. 

Yours truly, 

J. H. SWORTZEL. 



WASHINGTON. 
BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

King County, Wash., Dec. 20, 1895. 
A. A. Marks : 
Dear Sir : — During the last eighteen years I have been obliged to wear 

a substitute. I tried the , then the , and got fairly disgusted with both 

of them ; one day I met a friend of mine, an old army captain, who persuaded 
me to get one of your patent. I consented, and have worn it ever since. 
Every step I take brings^ 183 pounds to bear on it, and still the foot is as 
flexible as ever ; in fact, it has given me entire satisfaction. 

Truly, 

Thos. R. Hughes. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Kitsap County, Wash., Feb. 18, 1891. 
Mr. A. A. Marks : 

Dear Sir : — I am proud to say that your leg gives the best satisfaction. My 
occupation you know is farming ; I can do a good day's work with my leg. 

Yours respectfully, 

Ed. Good. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Mason County, Wash.,. Jan. 6, 1891. 
A. A. Marks : 

Dear Sir : — I have been using the leg since I got it and am pleased with it 
in every respect. One month after I received the leg, I was appointed as 
U. S. Indian Police, which office I now hold. I can do most any kind of 
work ; in fact I feel like a new man altogether, 

Yours very respectfully, 

Frank H. Peterson. 



WEST VIRGINIA. 
KNEE-BEARING AMPUTATION. 

Berkeley County, W. Va., Dec. 24, 1895. 
A. A. Marks : 

Dear Sir : — Now as to the merits of your rubber foot I will say they can 
not be excelled. The leg you made for me in 1870 was in constant use for 
fifteen years. The leg you made for me in 1875 I only commenced to wear iv 
1885, and am wearing it now. When the time comes for. me to get another, 
I shall call on you to make it. Yours respectfully, 

William Dean Smith. 



502 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Gilmer County, W. Va., Dec. 17, 1895. 
Mr. A. A. Marks, New York City : 

Dear Sir : — I have worn your patent leg with rubber foot for fifteen years. 
I walk with ease and alacrity. 

I have been engaged in lumbering for the last ten years, riding horseback as 
much as four to five days out of each week from place to place, and then walk- 
ing over logs to measure, etc. 

Yours most respectfully, 

John S. Brannon. 



BELOW-KNEE AMPUTATION. 

Harrison County, W. Va., Dec. 16, 1895. 
To Whom it may Concern : 

I have worn an artificial limb of Marks' patent for ten years, and I find it 
superior in every respect to any other. As merchant I am on my feet almost 
all day long, and do not suffer any inconvenience. This I think is owing to 
the fact that the foot is of rubber. Respectfully, 

M. J. Francis, P. M. 



BELOW-KNEE AMPUTATION. 

Lewis County, W. Va., Dec. 15, 1895. 
A. A. Marks : 
Sir : — I have worn artificial legs since 1864. The first order that I gave was 

for one of 's legs, which was tolerable. The next I ordered was one of 

yours ; it was very good. But, like all others, thinking there might still be a 

better one, I ordered one of , and it was a perfect nuisance, and then, 1881, 

fell back on your old stand-by leg. This I am still wearing. 

Jacob Stealey. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Webster County, W. Va., Dec. 18, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I am well pleased with your artificial leg. It enables me to 
walk with comfort and ease. My walk is natural. I can ride with the same 
comfort that I did with my natural leg. Occupation is farming. 

Yours respectfully, 

Levi Skidmore. 



WISCONSIN. 



BOTH LEGS AMPUTATED BELOW THE KNEES, AND PART OF 

ONE HAND. 

Fitted from Measurements. 

Eau Claire County, Wis., Dec. 20, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I have worn your limbs now for ten years and am well satisfied 
with them. I can walk right along with them. I have astonished a great 
many of my friends, and I have met strangers that never suspected anything 
of me being artificial. -I don't know what I would do without them. They 
are almost equal to the natural ones. 

Yours truly, 

William J. McDonough. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 503 



BOTH LEGS AMPUTATED BELOW THE KNEES. 

La Fayette County, Wis., Mar. 7, 
Mr. A. A. Marks : 

When but a mere boy of nine years of age, I lost both my feet through a too- 
close contact with a mower. Since then, for seventeen years, I have worn 
artificial limbs. I first tried a Chicago firm's make, then yours, which I have 
worn for eleven years. 

Your limbs were fitted perfectly from measurements ; they are very comfor- 
table, and do not irritate my stumps. The feet being of rubber, there is not 
the annoyance caused by feet with a complicated spring attachment. 

J. C. NODOLF. 



LEG ABOVE KNEE. 

Jefferson County, Wis., Dec. 18, 1895. 
A. A. Marks : 
Dear Sir :— I have your leg since 1885, and it is a good leg yet. 

M. S. Moses. 



ABOVE-KNEE AMPUTATION. 

Sauk County, Wis., Dec. 8, 1895. 
A. A. Marks, Esq., New York : 

Dear Sir : — I have worn an artificial leg of your manufacture since 1881, 
and so far am well pleased with it. 

Respectfully yours, 

C. Kuoni. 



BELOW-KNEE AMPUTATION. 

Dane County, Wis., Dec. 18, 1895.. 
A. A. Marks : 
Dear Sir : — You have made three artificial limbs for me, and they have all 

given complete satisfaction. The first leg I wore was a ; before I had 

worn it two years you could hear the ankle rattle for a long distance. The 
ankle joint in an artificial limb is a nuisance. I believe the rubber foot to be 
the best and safest. Yours respectfully, 

Harrison Sayles. 



BELOW-KNEE AMPUTATION. 

Green County, Wis., Dec. 21, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I have worn your patent leg for over ten years with perfect satis- 
faction. I want no other kind. I have worn an artificial leg nearly thirty- 
three years, and was always bothered with the springs and' ankle joint giving 
out. Yours has never troubled me any, and is apparently as good as new. 
The rubber foot is almost like the natural one. No dropping of toes, no swing- 
ing side-wear, but straight forward over rough ground or on sidewalk, or up 
and down hill. Very respectfully yours, 

Benjamin Wick. 



BELOW-KNEE AMPUTATION. 

Iowa County, Wis., Dec. 17, 1895. 
Mr. A. A. Marks : 

Sir : — I will state to you that I never had such a good fit for the List twenty- 
nine years. My leg is off nine inches below the knee. Ten years ago I was in 
your office. 
The rubber foot cannot be excelled. 

Yours truly, 

Daniel Lynch. 



504 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



BELOW-KNEE AMPUTATION. 

Jefferson County, Wis., Dec. 17, 1895. 
Mr. A. A. Marks : 

Dear Sir :— It is now over twenty-eight years ago since I bought my first 
artificial leg from you. I have tried several other makes in the meantime, but 
none of them have given me such satisfaction in any way. I have found yours 
the easiest and most comfortable, both for wear and walking, and also the most 
durable. Have been engaged in the stave and lumber manufacturing business 
all this time. I had to be around on my feet all day. 

Yours truly, 

Chris. May. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

La Fayette County, Wis. , Jan. 23, 1896. 
A. A. Marks, Esq., New York : 
Dear Sir : — I am doing all my housework, carrying wood, water, etc. 
I have worn artificial limbs since 1872. I am now wearing the fourth limb, 
which I purchased of you on or about July, 1885. 

It is giving me much better satisfaction than any of the other three which I 
purchased from different firms. My limb is amputated five inches above the 
ankle joint. You fitted me perfectly from measurements. 

Respectfully yours, 

Mrs. Wm. Krake. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Monroe County, Wis., Dec. 16, 1895. 
Mr. A. A. Marks : 

Dear Sir :— I have worn the leg you made for over twelve years, and am 
exceedingly well pleased with it. This is very well, considering that I have 
been laboring very nearly every day since I got it. My leg is amputated below 
the knee. I can heartily recommend your artificial limbs to anyone in need of 
such an article. 

Yours respectfully, . 

John Olson. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Winnebago County, Wis. , Dec. 18, 1895. 
A. A. Marks, Esq., New York : 

Dear Sir : — I have used one of your legs since 1881 and it has given perfect 
satisfaction. My leg was amputated below the knee, June, 1881, and measures 
for the same were taken before the stump had healed. 

I have worn the leg every day since. I am seventy.nine years old, and can 
walk without a cane or crutch. I am on my feet in the store from six o'clock 
in the morning till eight o'clock in the evening, and never think of using a 
cane except when I go on the street. 

The cost of repairs are nominal : a few dollars covers all expended on it. I 
think the rubber heel and toe and no ankle joint a great thing for people obliged 
to wear artificial limbs. 

Yours very truly, 

K. DlCHMAN. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



505 



BELOW-ELBOW AMPUTATION. 

Fitted from Measurements. 

Douglas County, Wis., Dec. 19, 1895. 
A. A. Marks, Esq., New York City : 

Dear Sir : — I thick my arm in every particular is a grand success, and I 
■will always be pleased to speak in its praise to my fellow-unfortunates. No 




1233. 



doubt you will be greatly surprised to know that I wrote this entire letter and 
addressed envelope with my hand. I think that if you will compare this with 
former letters of mine now in your possession, you will pronounce this the 
better writing of the two. 

Yours truly, 

Geo. H. Purchase. 



BELOW-ELBOW AMPUTATION. 

Fitted from Measurements. 

Marinette County, Wis., Dec. 5, 1887. 
A. A. Marks, Esq. , New York City : 

Dear Sir : — I take pleasure in stating that the arm you sent me was far 
beyond my expectations, and I do cheerfully recommend your artificial limbs 
to anyone who may need them. I am a painter by profession. 

Yours respectfully, 

Jos. E. Keefe. 



BELOW-ELBOW AMPUTATION. 

Milwaukee, Wis., Dec. 17, 1895. 
A. A. Marks, New York City : 

Dear Sir : — In July, 1886, I bought of you an artificial hand, for amputa- 
tion below the elbow. I have worn it constantly since. On many occasions it 
has been mistaken for a natural hand. As a glove is constantly worn, the 
hand suffers little from wear. I am satisfied with it, and would willingly 
answer any questions. Yours, 

J. H. Friar. 



506 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



. WYOMING. 

BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Uinta County, Wyo. , May 6, 1896. 
Mr. A. A. Marks : 

Dear Sir : — I am getting nearer perfection on the leg made by you every 
day and am much pleased with it. I do every kind of work I ever did before 
I lost my leg, and don't hesitate to tackle any work that comes in sight. I am 
only slightly inconvenienced. I can run, jump, dash, go over a train, shovel 
coal, shear sheep, in fact everything I ever did. 

Yours very truly, 

R. Lee Craig. 



KNEE-BEARING AMPUTATION. 

Fitted from Measurements. 

Sweetwater County, Wyo., Sept. 25, 1894. 
Mr. A. A. Marks : 

Dear Sir : — A little incident happened as I walked down the street the other 
day which I here will tell you. I heard one man ask another if he could tell 
which leg I had lost, and he stood and looked and said he could not. This 
makes me better pleased than ever with your leg. I am, 

Yours respectfully, 

J. E. Pearson. 



CANADA. 



ABOVE-KNEE AMPUTATION. 

Quebec, Canada, Dec. 5, 1895. 
A. A. Marks, Esq. : 

Dear Sir : — I have been wearing one of your artificial limbs over eleven 
years with the utmost satisfaction. Point of amputation about six inches from 
the hip joint, and I weigh two hundred and sixty-nine pounds. I am a watch- 
man in the G. T. Ry., and work from 7 at night until 7 in the morning. 

Respectfully, 

G. P. Hamel. 



ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Petite River, Nova Scotia, April 7, 1888. 
A. A. Marks : 

Dear Sir : — I am happy to inform you that the artificial leg you made for 
me works splendidly. I feel like anew man on it. This feeling is encouraged 
by the kindly comments of my friends. I regard the rubber foot as a great 
improvement. Yours truly, 

W. S. Freeman, M. D. 



BELOW-ELBOW AMPUTATION. 

Cumberland County, N. S., Canada, Dec. 19, 1896. 
Mr. A. A. Marks : 

Dear Sir : — It affords me much pleasure to say that I am willing that you 
should print my testimony in regard to the arm you manufactured for me. I 
can also state that I have been wearing it now for eight years with the best of 
satisfaction. Yours truly, 

S. E. Eagand. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



507 



BELOW-ELBOW AMPUTATION. 

Cape Breton, N. S., Canada, Jan. 3, 1896. 
A. A. Marks, Esq.: 

Dear Sir : — I am happy to say that, having worn one of your legs for the last 
fourteen years, I feel convinced that no better can be made. I have been for 
quite a while in the company of people who never suspected that I was depen- 
dent on a " cork leg " (as they will call it) for support. The limb you furnished 
the boy Daniel McLean from measurements taken by me has given good satisfac- 
tion, and he runs around with his playmates almost as if he had never met with 
a misfortune. 

Yours truly, 

R. A. H. MacKeen, M. D. 



BELOW-KNEE AMPUTATION. 

Montreal, Canada,, July 30, 1896. 
Mr. A. A. Marks : 

Dear Sir : — It affords me great pleasure to add my testimonial to the 
long list that you already have. I am a professional prestidigitateur. When 
I lost my leg, I realized the importance of getting an artificial one that 
would imitate nature in shape and action as well as possible. I traveled 
a great deal and examined the works of most of the manufacturers, and 




finally concluded that I could get the best results by wearing one of your 
legs with rubber foot. I have worn the leg nearly five years, and many of my 
most intimate friends do not know that I ever lost a natural leg. When I 
appear on the stage my steps are elastic and never betray the fact tfiat I wear 
an artificial leg. After having worn your limb about six weeks, I invited the 
surgeon who amputated my limb to witness my performance; he invited in 
turn his medical class. When I was called upon to show my artificial limb, 
you should have seen the expression on those students' faces — they could hardly 
believe it. I am, 

Your obedient servant, 

Mons. F. J. Bernier. 



508 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



BELOW-KNEE AMPUTATION. 

Manitoba, Canada, Jan. 26, 1896. 
Deab Sib : — After wearing one of your artificial legs for thirteen years con- 
tinuously, giving it the hardest of usage, and having worn one of the movable 
ankle-joint artificial legs previous to getting one of yours, I am in a position to 
give an opinion on the merits of each. I can recommend your artificial legs 
with rubber feet in preference to anything that I have seen or heard of as 
a substitute for the natural limb. 

Yours respectfully, 

Chas. O. Evans. 



BELOW-KNEE AMPUTATION. 

Quebec, October 29, 1893. 
A. A. Marks, Esq.: 

Dear Sir : — I take great pleasure in recommending your artificial limbs, 
especially for their durability. My left leg is amputated six inches below the 




knee joint. I have worn one of your limbs since 1888. I am employed as signal- 
man and attend to my duties without the least trouble. 

Thos. Feeney. 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Ontario, Canada, Dec. 16, 1895. 
Mr. A. A. Marks, New York : 

Dear Sir :— I procured a leg from you in 1876, for amputation four inches 
below the knee. I have worn your make of leg ever since. 

I am well pleased in every way. I think the rubber foot a great improve- 
ment on the ankle joint. As you are aware, I bought a second leg from you 
about ten years ago. It suits also very well. I have not been a whole day on 
crutches in twenty years. Yours respectfully, 

F. S. Rees. 






A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 509 



BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Quebec, Canada, Dec. 16, 1895. 
A. A. Marks, Esq.: 

My Dear Sir : — I might say that the first artificial leg you made for me in 
November, 1873, I wore constantly for twenty-one years. In all that time 
I don't think that it cost me over $10.00 for repairs. My occupation is a 
farmer, and I do all kinds of work that is usually done on a farm. 

The leg, with all your later improvements, which you made from measure- 
ments which I sent you in 1894, is giving the best of satisfaction. 

Yours sincerely, 

Thos. H. Nixon. 



NEWFOUNDLAND. 

ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Newfoundland, Jan. 2, 1896. 
A. A. Marks : 

Dear Sir : — It affords me unqualified pleasure to state that, having worn 
one of your artificial legs with rubber feet for a period of ten years, I find it 
all that is practical and useful, deserving the highest commendation. There 
are no other artificial limbs that fulfill their purposes so thoroughly and satis- 
factorily as yours do. 

Yours respectfully, 

Richard Dwyer. 



ABOVE-KNEE AMPUTATION. 

Fitted from Measurement. 

Newfoundland, Jan., 1896. 
Mr. A. A. Marks : 

Dear Sir : — I have been wearing one of your legs a little over nine years, 
and I can do almost anything but fly. I have walked twelve miles a day. 
I go shooting, fishing, and I don't care for any man. 

Yours very truly, 

Uriah Bursey. 



ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Newfoundland, Jan. 14, 1896. 
A. A. Marks, Esq.: 

Dear Sir : — Having had over twenty years' experience with artificial legs 
of various makers in the old country and in America, I find that the legs 
manufactured by A. A. Marks are the kind for me, for comfort, durability, 
gracefulness of movement, and satisfaction generally. 

Besides my own, I have measured and ordered from you limbs for seven 
different persons, among the number one female, all of whom speak in the 
most flattering terms of the splendid capabilities of the limbs made by your 
firm. 

Yours very truly, 

H. C. Morkis. 

[N. B. — Mr. Morris is competent to take measurements and attend to the 
details of ordering, receiving, and adjusting artificial limbs ; any person in 
need can place himself under his attention with the assurance of receiving 
proper care.— A. A. M.] 



510 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



THE FLEMING BROTHERS, EACH WEARING TWO ARTIFICIAL 
LEGS FOR AMPUTATIONS BELOW KNEES. 

Fitted from Measurements. 

Newfoundland fishermen remember well the cold storm that set in 
about the first of April, 1888. It was then that Edward and Peter 
Fleming-, brothers and fishermen of Forbay, met with a thrilling 
experience that deprived them of their lower extremities and nearly- 
cost them their lives. 

They were fishing- from the ship's yawl off the coast of Newfound- 
land, when a storm suddenly came upon them and drove them from 
their location and away from the relief of the vessel. Twelve days 
they drifted about at the mercy of the cold, wind, and ocean — fam- 
ished, athirst, and frozen ; nothing to eat, nothing to drink, no succor, 
no hope. When despair and suffering had nearly exhausted them, 
a bark bound for Quebec picked them up and cared for them the 
best they could; but their sufferings were not alleviated until they 
were placed in the Quebec Hospital, where it was found necessary to 
amputate both legs of each. In course of time Peter and Edward sent 
their measurements to A. A. Marks of New York for two pair of arti- 
ficial legs. 

The letter printed below tells the results. 

Newfoundland, Oct. 29, 1895. 
Mr. A. A. Marks: 

Dear Sir : — In regard to the artificial limbs you made for me six years ago, 
they are wearing well yet. They never cost me one cent for repairs since I 
got them. I was speaking to several men on crutches, and I told them that I 
had two of your limbs. They were surprised and wished they could get the 
like of them. I do a great deal of walking around the ground in summer 
time. I cannot praise your limbs too highly, for they are a great comfort. 

Yours truly, 

Edward Fleming. 



MEXICO. 

ABOVE-KNEE AMPUTATION. 

(Translated from the Spanish.) 

Orizaba, Mexico, Dec. 20, 1895. 
A. A. Marks : 

Dear Friend : — I can assure you.vto-day that in this world nobody could 
construct apparatus such as yours, which are so useful, so easy to wear, and'so 
perfect that they bear a great resemblance with the natural ones. . Conse- 
quently I do not feel surprised to hear that they have always obtained the first 
prizes when presented in the exhibitions, as they only reveal justice and venera- 
tion to the acknowledged merit of your limbs. Therefore, I heartily congratu- 
late you and remain once more your faithful friend, 

Enrique Guasp de Paris. 



ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

(Translated from the Spanish.) 

Zacualtipan, Mexico, Dec. 29, 1895. 
A. A. Marks, Esq., New York : 

Dear Sir : — I beg to say the leg you made me is much more satisfactory 
than the one I used before. I can walk perfectly with it, although the ground 
is very uneven here. I feel very grateful to you, as all should be who have 
been relieved by you as I have been, after so much suffering. 

Respectfully, 

Adolfo Perez. 



A. A. MAEKS, ARTIFICIAL LIMBS, NEW YORK CITY. 511 

BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Danced at his wedding. 

(Translated from the Spanish.) 

Santa Rosalia, Mexico, Sept. 5, 1887. 
A. A. Marks, New York : 

Dear Sir : — When I gave my order I never imagined that an artificial leg 
could form so perfect a substitute for the natural one in walking, riding on 
horseback, and even dancing ; I supposed it would merely serve to hide the 
defect. , 

For your satisfaction and my own I would beg to state that experience has 
demonstrated to me the superiority of the artificial legs with the rubber foot, 
because they combine simplicity of construction with stability and ease in 
walking, aside from the consideration of their extreme durability. I seize this 
opportunity of expressing my gratitude toward yourself for having devoted 
your energies to the alleviation of mankind in a branch so important as that of 
manufacturing artificial limbs, the construction and adaptation of which you 
so thoroughly understand. 

Very sincerely yours, 

Antonio Alarcon. 



COSTA RICA, C. A. 

ABOVE-ELBOW AMPUTATION. 

Fitted from Measurements. 

Costa Rica, C. A., Feb. 8, 1896. 
A. A. Marks, New York City, N. Y. : 

Dear Sir : — I have the pleasure of stating that immediately after having 
sent you the measurements for my left hand, amputated two inches below the 
shoulder, I received from you in the month of January, 1885, an artificial 
rubber limb, which fits me perfectly well, and serves me up till now without 
any repairs at all. By reason of my occupation necessitating my frequent ap- 
pearing in public places, I can fully appreciate what a boon your workas doing 
to humanity. 

I am, gentlemen, yours thankfully, 

Jose Monge Reyes. 



SAN SALVADOR, C. A. 

ABOVE-KNEE AMPUTATION. 

Perez & Parraga. 
San Salvador, Central America, July 14, 1896. 
Mr. A. A. Marks, New York : 

Most Esteemed Sir : — It is nineteen years since I obtained an artificial leg 
from you. During this period I have not had an opportunity to find the least 
fault with it. I walk very much and without a cane or support. I suffer no 
pain or uneasiness from it. 

Since I have returned to Central America I find it necessary to make long 
journeys on horseback. In this the leg has assisted me very much. I pride 
myself on my easy and graceful movements, and the facility with which 
I mount and dismount. 

The india-rubber foot which is on the artificial leg is a most excellent inven- 
tion ; without it I question my ability to walk with safety in this country, the 
streets are so very rough and stony. 

Your attentive friend, 

Manuel A. Parraga. 



512 A. A. MARKS, ARTIFICIAL LLMBS, NEW YORK CITY. 



PERU, S. A. 

LETTER FROM THE SOX OF THE PRESIDENT OF THE REPUBLIC 
OF PERU.— ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Lima, Peru, South America, Nov. 25, 1885. 
Mr. A. A. Marks, New York City : 

My Dear Sir :— I take great pleasure in assuring you that the artificial leg 
which I ordered of you to replace the one I lost in the engagement of August 
.27, 1884, has proved to my entire satisfaction. 

It is just that I should recommend your work, since I have been enabled to 
avail myself of it to such advantage. 

Yours very truly, 

Absolon M. Yglesias. 



CHILE, S. A. 
BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Cerro Blanco, Carrizal Bajo, 

Chile, S. A., August 24, 1887. 
Mr. A. A. Marks, New York : 
Dear Sir : — The fit is perfect and my son is able to use the leg with tht 

greatest comfort. 

My son begs me to tender you his most earnest and heartfelt thanks for the 
blessing that~you have been the means of rendering to him. 

Yours very faithfully, 

E. T. Martin. 



CUBA. 

KNEE-BEARING AMPUTATION. 

Fitted from Measurements. 

Santiago de Cuba, Feb. 21, 1896. 
Mr. A. A. Marks : 

Dear and Most Honored Sir : — Gratitude is one of the noblest sentiments 
of the human heart. My duty is not only to express my gratitude to you, but 
to pay a tribute of justice to merit. 

Every day I am more thankful for the leg of your manufacture which I am 
using. " I remain, 

Your affectionate and obedient servant, 

Joaquin Ricalo Mugtjercia. 



JAMAICA, W. I. 

BELOW-KNEE AMPUTATION. 

Fitted from Measurements. , 

Jamaica, W. I., Jan. 15, 1896. 

I have worn one of the Marks' artificial legs with rubber foot for eleven 
years, and must accord to him all the merits in the line of the manufacturing 
of artificial limbs, its durability, its ease, and simplicity. 
^ I take my usual pleasure in sporting, going over hills and dales without the 
sign of fatigue or inconvenience. 

I am a carpenter and do a large amount of walking, and my artificial leg 
has a great deal of wear and tear. 

R. D. Mothersxll. 



A. A. MABKS, ARTIFICIAL LIMBS, NEW YORK CITY. 513 

WEST INDIES. 

KNEE-BEARING AMPUTATION. 

Fitted from Measurements. 

Porto Rico, May 20, 1896. 
Mr, A. A. Marks : 

Dear Sir : — I see no reason why my name should not appear in your new 
treatise, since from 1882 until to-day I have used the same artificial leg without 
having sustained any deterioration in that time. Expressing to you my most 
sincere thanks for the good service that limb has given to me, by which I 
work and earn my daily bread, I remain thankfully, 

Your affectionate friend, etc., 

Jose Maria Lebron. 



ENGLAND. 

ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Gladstone Terrace, Queen's Road, Runcorn, 

Cheshire, England, Dec. 26, 1895. 
Dear Sir :— I have now worn your leg for thirteen years, and am very glad 
to say I am quite satisfied with it. I was fitted from measurements. The 
point of amputation is about two inches above the left knee. 

I am glad to be able to say the cost of repairing the limbs made by you is so 
little that I could not attempt to reckon it up. 

Yours truly, 
To A. A. Marks, Esq. Walter Lacy. 



IRELAND. 

BELOW-KNEE amputation. 

Fitted from Measurements. 

Belfast, Ireland, June 27, 1884. 

Dear Sir : — The leg arrived some time about the latter end of June, 1875, 
and I have been wearing it ever since. I would like to get another just like 
it. The limb I have has a rubber foot for amputation below the knee. It is 
a pity you have not an agent here, for there is only one party in this city who 
makes artificial legs, and they are not to be compared with yours for durability, 
neatness, and comfort. 

Trusting to hear from you soon, 

Yours respectfully, 

Dr. Marks. Samuel McKee. 



HOLLAND. 

ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Amsterdam, Holland, Nov. 23, 1887. 
Mr. A. A. Marks, New York : 

Dear Sir : — I take much pleasure in certifying that the two new legs you 
furnished me from measurements, give me great satisfaction in every respect. 
I have never seen legs of better construction, and I do not believe that any 
other kind would need less repairs. • 

The rubber foot and the knee joint are far superior to all others lever saw ; 
hence, I can strongly recommend your highly respectable firm to all others. 
I lost my left leg above knee, in the year 1872. 

Respectfully yours, 

* Fr ancis Herckenrath. 



514 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 

GERMAN Y. 

BELOW-ELBOW AMPUTATION. 

Fitted from Measurements. 

Lubeck, Germany, Jan. 2, 
A. A. Marks, Esq., New York City: 

Dear Sir : — In regard to the artificial hand I got of you nine years ago, I 
can say it exceeds my expectation. 

If I were compelled to work for my living the rubber hand Would be of 
great use in any occupation. I recommend the rubber limbs to anyone who 
has had the misfortune to become crippled. 

Yours respectfully, 

N. MlLDENSTEIN. 



DENMARK. 

ABOVE-KNEE AMPUTATION— STUMP ONE AND SEVEN- 
EIGHTHS INCHES LONG. 

Fitted from Measurements. 
Mr. A. A. Marks : 

Dear Sir : — When thirteen years old, I lost my right leg and used a com- 
mon wooden leg till I reached forty-four years. By this time my attention 
was called to your artificial legs with rubber feet. I sent you my measure and 
got a leg from you, which I have used ever since, now for about six years. I 
am very well satisfied with it. It fits me admirably, and has required no re- 
pairs worth mentioning. The new suspenders are a real improvement. The 
stump, though only one and seven-eights inches, has never been sore. 

Yours gratefully, 

G. Heineman. 
Copenhagen, Denmark, Nov. 21, 1887. 



NEW ZEALAND. 

ABOVE-KNEE AMPUTATION. 

Fitted from Measurements, 

Auckland, April 12, 1896. 
Mr. A. A. Marks : 

Dear Sir : — I have worn one of your legs since 1889, and have hardly had 
it off in all that time for a single day, and the last four years I have been liv- 
ing back in a new settlement where everything is very rough. I have often 
been fourteen hours on horseback at a time, either stock riding or packing, 
and during the winter do my share of bush, felling. The rubber foot acts 
splendidly. I am, Yours faithfully, 

Norman Cole-Baker. 



ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Shag Valley Station, Waihemo, Otago, N. Z., July 10, 1884. 
You may be pleased to hear that Mr. Trapski is successfully using the leg 
you made for him and can walk easily and quickly. He has every reason to 
be grateful to you for the trouble taken in his case, and will, I'm sure, readily 
recommend your firm to anyone suffering from a like misfortune. In this 
recommendation I shall gladly join. 

Frank D. Bell. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



515 



Wanganui, N. Z. , June 12, 1894. 

A. A. Marks : , i# _ . . . ' 

Dear Sir :— On September, 1892, you forwarded to me an artificial leg for 
my son. It has given the greatest satisfaction. My son has worn it continu- 




ously ; he can do all sorts of work, he can walk all day in a rough country and 
never becomes sore or lame. He has jumped teji flight of hurdles, 3 feet 3 
inches high, in 120 yards. I have seen him jump a standard wire fence. 

CM. Taylor. 



HAWAIIAN ISLANDS. 

BELOW-ELBOW AMPUTATION. 

Fitted from Measurements. 

Hawaii, July 20, 1896. 
Mr. A. A. Marks : 

Dear Sir : — I cannot give enough praise for the best material that you used 
in making my artificial hand, for it has stood the test well, and in many of my 
falls the artificial hand has saved me from accident. I am a cattle rancher. 
My hand was badly lacerated by being fouled with a lariat while lassoing wild 
cattle on the mountains here. The loss of my arm does not in any way deter 
me in my business. I remain, dear sir, 

Yours very truly, 

Eben P. Low. 



STRAITS SETTLEMENTS. 



ABOVE-KNEE AMPUTATION. 

Fitted from Measurements. 

Singapore, March 16, 1896. 
Mr. A. A. Marks : . 

Dear Sir :— The first trial on your artificial leg I found to be a bit awkward, 
as I had been accustomed to those that had ankle joints, but after using it 
a while, I find that I can walk better and faster with your make. The knee 
joint is very safe in walking, as it does not bend suddenly when least expected, 
and the roller suspenders are far more comfortable to wear than the old style. 
I remain. 



Yours respectfully, 



J. H. Siddons. 



516 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



JAPAN. 



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t « 



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-* jgt 3* - / 



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[translation.] 
Japanese Legation, Washington, D. C, Dec. 23, 1889. 
Mr. A. A. Marks : 

Dear Sir : — I have worn an artificial leg with rubber foot made by you for 
the past five years, and assure you it has given me the best of satisfaction. I 
heartily recommend your work. I shall gladly speak well of it to all my 
countrymen afflicted as I am when I return to Japan. 

Respectfully yours, 

K. Saigo. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 517 

ARTIFICIAL LEG, AMPUTATION ABOVE KNEE, FOR HIS EXCEL- 
LENCY THE COUNT OKUMA OF JAPAN. 

Fitted from Measurements. 

Waseda, Tokio, Japan. 
I am desired by His Excellency Count Okuma to inform you that the arti- 
ficial leg which you made for him reached here some time ago in very good 
condition. The Count is exceedingly gratified with the admirable workman- 
ship of the leg, and has already made considerable progress in walking with its 
assistance. The artificial teg suits him. remarkably well, and apparently 
requires no alteration. 

Yours truly. 

T. Kato. 

/§ % f*> m a- **. & 

i +i * O M & \ 
J i Vf & sL m 

X /* & '■*& y\ it '■% 

1 ft' I $ ft* 

fl± ■ AS f <*r ^[ *-> M m 

t * * J* 'i t t 



* > j« r a i 1 1 



518 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



SOUTH AFRICA. 

BELOW-KNEE AMPUTATION. 

Fitted from Measurements. 

Cape Colony, June 16, 1895. 
Mr. A. A. Marks : 

Dear Sir : — I am very much pleased with your artificial leg ; it is a perfect 
fit. I have made up my mind never to have an ankle-joint foot again. There* 
are a great many of my friends who would not believe that the leg would be 
as you advised, unless I went to the factory, but my case has completely altered 
their opinion. I would almost defy anyone to detect that I am a cripple. The 
doctor who assisted me with the measurements is so well satisfied with my 
case, that he is going to order for his other patients. The rigid ankle and 
rubber foot, and the noiseless action, is not only an agreeable surprise to myself, 
but more so to those who know me. 

Gratefully yours, 

W. H. Forest. 



FOREIGN MONEY EQUIVALENTS. 

The prices given in our books are in United States money. Parties ordering artificial limbs 
or supplies can make remittances in their own national money or any money that may be most, 
available. The following table has been computed according to the rates of exchange Decem- 
ber 1st, 1899. The rates fluctuate more or less every day, but the variations from the rates given 
in the table cannot be very great. 




A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY 



19 



STUMP SOCKS FOR ARTIFICIAL LIMB WEARERS. 

A stump bears the same relation to an artificial leg that a natural 
foot does to a shoe. Comfort and cleanliness demand that a sock 
should be worn on the stump, the same as on the foot. 

A sock in either case provides a medium for collecting and absorbing 
the particles of waste and moisture that are thrown off from the skin, 
and by removing the socks, airing, and frequently washing them, the 
stump will be kept in a more healthy condition, and the socket of the 
leg will be better cared for. 

There are persons who do not use socks, but wear their artificial 
limbs directly to their stumps, and permit the sockets to collect and 
absorb the excrements of the skin, and when the sockets become foul 





No. 1245. 



No. 1246. 




No. 1247. 



with a collection of effete matter, they are scraped out and revarnished. 
This method cannot be condemned too strongly. The stump, as well 
as the artificial leg, suffers from such untidy treatment. 

Every wearer of an artificial limb should be provided with an ample 
supply of socks, so that frequent changes can be made. The same 
regard should be given to the stump as is given to the natural foot. 
If a stump perspires excessively, changes should be made more fre- 
quently. 

We manufacture our own socks, and keep a large stock on hand and 
are able to fill orders promptly. The yarn for our woolen socks is 
especially prepared at the mills for our purpose. It is the best and 
softest that can be procured, and absolutely free from cotton or any 
foreign fiber, and our cotton socks are made of the choicest staple that 
can be put into thread. 

They are made in white or brown, as may be preferred. 

Our stock consists of eleven different sizes, ranging from 10 to 36 
inches in length, and wide enough to fit any ordinary stump. 



520 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



In ordering socks, the following measurements of the stump should 
be given : 

Length from body to end. 
Circumference of limb close to body. 
" 4 inches below " 

<t o (< a t( 

(< 12 " " " 

u -iq a <t <( 

(I 2Q It (I it 

a 04 ti ' it ' it 

U gg U « (( 



In drawing a sock on a stump, it becomes expanded. This shortens 
it in length, therefore, five inches should be added to the length of the 
stump in order to be sure of having a sock sufficiently long for the 
purpose. 

Some persons use a long sock to extend from the end of the stump to 
the body, and a shorter one to extend from the end of the stump to the 
joint (knee or elbow). 

When a short one is needed, give only the length and circumferences 
of that part of the limb that is to be covered. 

The following schedule will enable anyone to determine the sizes and 
the prices of the socks required. 



Sizes. 


Cotton. 


Woolen. 


No. 


Length of Sock , 
in inches. 


Circumference at larg- 
est part of Stump, in 
inches. 


Price, 
Each. 


Price, 

per 

Dozen. 


Price, 
Each. 


Price, 

per 

Dozen. 



1 

2 
3 
4 
5 
6 
7 
8 
9 
10 


ItolO 
10 to 15 
10 to 15 
15 to 20 
15 to 20 
20 to 25 
20 to 25 
25 to 30 
25 to 30 
30 to 35 
30 to 35 


Under 15 
" 15 
Over 15 
Under 15 
Over 15 
Under 15 
Over 15 
Under 15 
Over 15 
Under 15 
Over 15 


$0.20 
.30 
.40 
.40 
.50 
.50 
.60 
.60 
.70 
.70 
.80 


$2.00 
3.00 
4.00 
4.00 
5.00 
5.00 
6.00 
6.00 
7.00 
7.00 
8.00 


$0.40 
.50 
.60 
.60 
.70 
.70 
.80 
.80 
.90 
.90 
1.00 


$4.00 
5.00 
6.00 
6.00 
7.00 
7.00 
8.00 
8.00 
9.00 
9.00 

10.00 



One-quarter or one-half dozen sold at dozen rates. 

Socks and supplies will be sent by mail free of postage on receipt of price. 



WEBBING. 

Elastic webbings, 2 inches wide, 60c. per yard; 1£ inch wide, 50c. 
per yard ; 1 inch wide, 40c. per yard. 

Non-elastic webbings, 2 inches wide, 30c. per yard ; 1| inch wide, 25c. 
per yard; 1 inch wide, 20c. per yard. 



A. A. MARKS, AETIFICIAL LIMBS, NEW YORK CITY. 



521 



MARKS' IMPROVED KNIFE AND FORK -COMBINED. 

Operated by a press button. Press the button and the blade flies open. 

CUT REPRESENTS THREE-QUARTER SIZE. 




The combination knife and fork illustrated here is 
designed for the convenience of those who are tempo- 
rarily or permanently disabled in one hand, either right 
or left. A lock and spring are imbedded in the knife, 
which operate on the blade. No. 1263 represents the 
closed knife with thumb applied to the press button. 





The moment a little pressure is applied to this button the blade will fly open 
and become locked, as shown in No. 1264. When opened, a piece of meat 
can be cut on the plate by a rolling motion given to the knife, as represented 
in No. 1265 ; the knife can be inverted by twisting the hand (see No. 1266), 
and food conveyed to the mouth by means of the fork. The blade cannot close 




No. 1265. 



No. 1266. 



when pressure is applied to the fork. Butter can be spread upon bread, potatoes 
mashed, and other services performed. Pressure applied to the press button 
will release the lock, and the knife can be closed and locked and carried in the 
pocket. The blade is made of steel, and the handle of aluminum. It is very 
strong and durable. Price $2.00, postpaid. 



522 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



THE PRESS-BUTTON POCKET KNIFE.— A HANDY KNIFE FOR 
ANYONE-ONE HAND DOES IT ALL. 

CUTS REPRESENT THREE-QUARTER SIZE. 

The press-button feature, as described on the preceding page, is here com- 
bined with an ordinary pocket knife. Many persons have broken their nails 
and made their thumbs sore by pulling open blades by means of the nails. 
The feature of locking the blade when open, as well as when closed, is another 
valuable improvement upon the old method. Probably every person who has 
used a penknife to any considerable degree can recall the experience of having 
the blade close upon their fingers unexpectedly. The press-button feature 
removes all these dangers. The knife cannot be opened, and when opened 
cannot be closed, unless pressure be applied to the press button. The moment 
pressure is applied, the blade opens and becomes locked. We have a variety 
of shapes and sizes that we are offering to the public, especially to those who 
have lost one hand. The blades are made of the finest Sheffield steel. 




Style E, Blade and Button Hook, Price $1.00, postpaid. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY 



523 



CRUTCHES. 

The crutches offered here are of exceptionally good quality; they are neat 
in design, strong, reliable, and elegantly finished, especial care being given to 
their construction and the selection of material. Rock maple is found to 
be the most desirable wood, and is used more abundantly than any other. 
The grain is straight and tough, the color is light, and when a light-colored 
crutch is objectionable, we have the wood in some styles stained black walnut. 
Rosewood is also used; it is a dark-colored wood, and when highly finished 
makes crutches that are rich and elegant in appearance. 

The hand-rests are secured to the side bars by coppered Bessemer steel rods 
passing through them and riveted to each side bar. This is an improvement 
upon the older method, viz., placing the hand-rests between the side bars and 
securing them by screws. Many crutches have broken and let their wearers 
fall, simply because the hand-rests were not properly secured. 




No.1268 



No.1269 



No.1270 



No.1271 



No. 1268. Whittemore pattern. Side bars of straight-grain timber, steamed 
and bent, arm-rest of genuine Peb. goat with an eight-ounce duck lining 
stuffed with A No. 1 curled hair, and firmly secured to each side bar; the soft 
top yielding under the weight of the wearer makes a very delightful rest for 
the arm; patent clamp ferrules style No. 1277 are used. All trimmings 
nickel-plated. The crutch is elegantly polished. 

Price, per pair, rosewood, $8.50 

" " " rock maple, stained black walnut, . . . 7.50 
" " " rock maple, natural color, . . . .6.50 
Single crutch, rosewood, $5.00; stained, $4.50; rock maple, $4.00. 
No. 1269. Arm-rest is carved to the shape of a cow's horn and highly 
polished. It is therefore called the cow-horn crutch; some experienced 
crutch-wearers say that a hardwood arm-rest, smooth and highly polished, 
is more pleasant than the padded or soft arm-rest, as it does not wear the 
clothing or cramp the shoulder as much as other kinds; patent clamp ferrules 
style No. 1277 are used, full nickel-plate trimmings. 

Price, per pair, rosewood, with rosewood arm and hand-rests, $8.50 
" " " rock maple, natural color, with cherry arm- 

and hand-rests, .4.25 

Single crutch, rosewood, $5.00; rock maple, $2.50. 



524 



A. A; MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



No. 1270, same style as No. 1269, rock maple, except that ferrules No. 1288 
are used on bottom, full nickel-plate trimmings. 

Price, per pair, rock maple, stained black walnut, . . . $4.25 
" " " " rock maple, natural color, .... 3.25 
Single crutch, stained, $2.50; rock maple, $2.00. 
No. 1271, same style as No. 1269, except that plain brass ferrules on bottoms 
are used; plain brass trimmings. 

Price, per pair, rock maple, natural color, . . . . $2.50 
Single crutch, $1.50. 



No.1272 



No.1273 



NoJ274 



Ne.1275 



No. 1272. Side bars rock maple, cherry hand-rests, arm-rests upholstered 
with hair covered with enameled leather; ferrules No. 1288 are used, full 
nickel-plate trimmings. 

Price, per pair, rock maple, stained black or ebonized, . . $4.50 
" " " rock maple, natural color, . . . . 3.50 

Single crutch, ebonized, $2.50; natural color, $2.00. 
No. 1273, same style as No. 1272, excepting that plain brass ferrules on 
bottoms are used, plain brass trimmings. 

Price, per pair, rock maple, natural color, .... $2.75 

Single crutch, $1.50. ■* 

No. 1274. Side bars, rock maple, cherry hand- and arm-rests, not upholstered; 
simple brass ferrules on bottoms. 

Price, per pair, rock maple, natural color, . . . . $2.00 

Single crutch, $1.25. 
No. 1275. Side bars, rock maple, cherry hand- and arm-rests; side bars are 
one piece, split from the top to nearly the bottom, where they are riveted; 
the bottom is without ferrule. 

Price, per pair, . . . . . . . $1.50 

Single crutch, $1.00. 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 525 

CRUTCH FERRULES AND CRUTCH RUBBERS. 

CUTS REPRESENT ONE-HALF SIZE. 




No.1276 





No.l*80 



No.1281 



No.lE8a 



No. 1276. Patent clamp ferrule, heavy brass, nickel-plated, will screw on 
the end of a crutch one inch in diameter. 

Price, per pair, including No. 1280 tips, . . . . $2.50 

No. 1277. Patent clamp ferrule, heavy brass nickel-plated; will screw on the 
end of a crutch three-quarters of an inch in diameter. 

Price, per pair, including No. 1281 tips, $2.00 

No. 1278. Patent clamp ferrule, heavy brass, nickel-plated; will screw on 
the end of a crutch or cane one-half inch in diameter. 

Price, per pair, including No. 1282 tips, . . . $1.75 

No. 1279 merely illustrates the patent clamp ferrule with jaws distended; by 

unscrewing the jaws they can be opened, when a rubber tip can be placed 

between them; by screwing them up tightly they will close and hold the tip 

securely. 

No. 1280. Rubber tip, with base one and one-quarter inch in diameter (fit 

No. 1276 ferrule). Price, per pair, $0.30 

No. 1281. Rubber tip, with base one inch in diameter (fit No. 1277 ferrule). 

Price, per pair, $0.15 

No. 1282. Rubber tip, with base three-quarters inch in diameter (fit No. 1278 

ferrule). Price, per pair, . , $0.10 

No. 1287. Heavy brass ferrule, nickel-plated; will screw on the end of 
a crutch one inch in diameter. 

Price, per pair, including No. 1290 tips, $1.85 



526 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



No. 1288. Heavy brass ferrule, nickel plated; will screw on the end of 
a crutch three-quarters of an inch in diameter; 

Price, per pair, including No. 1291 tips, $1.00 

No. 1289. Heavy brass ferrule, nickel-plated; will screw on the end of a 
crutch or cane one-half inch in diameter. 




No. 1290 



No.1291 



No.l29£ 



Price, per pair, including No. 1292 tips $0.75 

No. 1290. Rubber screw tip, base one and one-half inch in diameter; will 
screw in the end of No. 1287 ferrule. Price, per pair, . . $0.40 

No. 1291. Rubber screw tip, base one and one-quarter inch in diameter; will 
screw in the end of No. 1288 ferrule. Price, per pair, . . $0.20 

No. 1292. Rubber screw tip, base one inch in diameter; will screw in the 
end of No. 1289 ferrule. Price, per pair, $0.15 

No. 1300. Rubber ferrules are made in several sizes to fit the ends" of 
crutches and canes; they slip on the ends of crutches and take the place 
of brass ferrules; they provide a soft medium between the end of the crutch 
and the ground; they prevent slipping and obviate noise and marring the 
floors; they are not as durable as any of the rubber tips previously described. 

Prices as follows: 



1300—15. 


Diameter of hole 


fin. 


base, fin., 


per pair, 


. $0.20 


1300—16. 


« 


**■ 


" |« 


< < it 


.20 


1300—17. 


.. 


f " 


" li" 


ii 


.20 


1300—18. 


<< (< 


t" 


" li" 


" 


.20 


1300—19. 


<« it 


1" 


" 1£" 


< i < < 


.25 


1300—20. 


<< «i 


1 " 


" li" 


ii ii 


.25 


1300—21. 


« 


1£" 


" If" 


a it 


.25 


1300—39. 


Diameter of hole 


Hin. 


, base, 2-J in. 


, each, 


. 1.00 



(Suitable for peg legs.) 
1300 — 44. Diameter of hole 1|, in., base, 3 in., each, 
(Suitable for peg legs.) 



1.50 



A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



527 



INVALID RECLINING AND ROLLING CHAIRS. 

No. 1350 represents an Invalid Reclining Chair. This chair is 
easily adjustable to any position, from upright to recumbent, that 
^~^ may be assumed by the occupant ; and when 

the desired point is reached, is fastened by 
means of our new improved cam fastener, 
which is operated by the occupant. 

Casters are put on each leg. It can be 
folded readily for packing away or ship- 
ment. The foot-board turns up against the 
leg-rest for convenience in getting into and 
out of the chair. 

The back and seat are caned, the arms 
No - 135 °- wood. 

When folded this chair occupies a space forty-five inches long, 
twenty-four inches wide, and eight inches deep. 

DIMENSIONS. 

Height of Seat from floor, . . . . .20 inches. 

Width of Seat, 19 " 

Height of Back from Seat, . . . . . . 34 " 

Height of Seat from Foot-board, . . . . . 17 " 

Price, Oak, $13 each ; Black Walnut, $14 each. Arms upholstered, $1 extra. 

No. 1351 represents an Invalid Rolling- Chair. This Rolling 
Chair is not reclining, but has the same wheels and axles as No. 1355 
Reclining Chair, the difference in the construction being in the style 
of chair used. The chair has no hand rims on 
wheels as in No. 1355. 




21 inches. 
18 

m 

20 
17 
101 
30 




No. 1351. 



DIMENSIONS. 

Height of Back from Seat, 
Width of Seat, .... 
Depth of Seat from front to back, 
Height of Seat from floor, . 
Height of Seat from Foot-board, 
Height of Arms above Seat, 
Height of Wheels from floor, . 
Weight of Chair, about 40 pounds. 

Will pass through a doorway not less than 

28 inches wide. 
Price, Oak, $16 each. Hand Rims added at 

additional cost of $2. 

No. 1352 represents an Invalid 
Reclining Rolling Chair. Although not 
as desirable as the more expensive ones, 
it is strong, serviceable, and comfort- 
able, and those unable, to purchase the 
higher-priced chair will find it to answer 
No 135 2 - the same purpose nearly as well. It 




52b 



A. A. MASKS, ARTIFICIAL LDIBS. NEW YORK CITY. 



can be used and fastened in any position, from upright to recumbent. 
Axles and wheels are same as No. 1355, except wheels have no hand 
rims. 

DIMEVSIOXS. 

Height of 3ack from Seat, 34 inches. 

Height of Seat from r oor, 20 " 

Height of Seat from Foot-board, 17 " 

Depth of Seat, front to back, 19 " 

Height of Wheels, " . . . 30 <f 

Width of Seat, 19 " 

Height of Arms above Seat, 9^ " 

Will pass through a doorway not less than 28 inches wide. 

Price, Oak, Caned, $25 each. Hand Rims $2 extra. 

Xo. 1353 represents an Invalid Rolling Chair. This Rolling 
Chair is not reclining, but has the same running parts as No. 1355 
Reclining Chair. This chair has hand 
rims on wheels for street use. 

DEtfEXSIOyS. 

Height of Back from Seat, . . 30 inches. 
Width of Seat, . . . . 19 

Depth of Seat from front to back, .18 " 
Height of Seat from floor, . . 20 " 

Height of Seat from Foot- board, . IT 
Height of Arms above Seat, . 8i " 

Height of Wheels from floor, . .30 

Weight of Chair, about 40 pounds. Will pass 
through a doorway not less than 28 inches wide. 

Price, Oak, $26 each ; Black Walnut, $29 each. 

Xo. 1354 represents an Invalid Rolling Chair. This chair is 
for street use, to be pushed by an attendant. The 
body is placed on springs, and has a detachable 
push-handle. The foot-board turns up against the 
front, or can be used as a step when getting into the 
. chair. The front wheels can be lifted from the 
ground in passing over obstructions* 

DOIEXSIOXS. 

Height of Back from Seat, . 24 inches. 
Height of Back Wheels, . 28 " 

Height of Front Wheels, .13 " 

" ■" " ' Height of Seat from floor, . 23 

Height of Seat from Foot-board, 16 " 
Xo. 1354. Width of Seat, . . . 18 " 

Will pass through a doorway not less than 28 inches wide. 
Price, Oak, $31 each. 

Xo. 1355 represents an Invalid Reclining Rolling Chair. This 
chair is one of the most popular Reclining Rolling Chairs made, 
and contains all of the improvements. The following illustration 
shows one of the several positions that it may be placed in. 





A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 



529 



34 inches. 

19 " 

19 " 

20 " 
17 " 

H " 

30 " 



DIMENSIONS. 

Height of Back from Seat, . 
Width of Seat, .... 

Depth of Seat from front to back, 
Height of Seat from floor, 
Height of Seat from Foot-board, 
Height of Arms above Seat, 
Height of Wheels, 
Weight of chair, about 60 pounds. 
Caster Wheel 10 inches in diameter. Will pass 
through a doorway not less than 28 inches wide. 
Upholstered chairs have the arms upholstered and 
leg- rest caned. 
Prices, Oak, Caned, $34 each ; Black Walnut, 
$37 each ; Oak, Upholstered with all-wool Terry, Hair Cloth, or Tapestry, 
Spring Back and Seat, $42 each ; Black Walnut, Upholstered with all-wool 
Terry, Hair Cloth, or Tapestry, Spring Back and Seat, $45 each. Leg-rest, 
Upholstered, $2 extra. 

No. 1356 represents the recumbent position of chair No. 1355. 
Any position can be obtained by a little effort on the part of the occu- 
pant ; a handle, easily grasped by the right hand, can be moved one 
way or the other in order to fasten the chair in any desired position. 
The wheels have hand rims for street use. The tires are half 
round. The foot-board turns up against the leg-rest for conveni- 




Ko. 1355. 




No. 1356. 

ence in getting in and out of the chair. This description also refers 
to Nos. 1357 and 1358. 

No. 1357 is the same as our No. 1355, but with the addition of 
Tempered Steel Eliptic Springs placed between the seat and gear, 
thus preventing the jar caused by rolling over uneven ground, and 
making it very desirable to use out of doors. 

DIMENSIONS. 

Height of Back from Seat, . ... . . .34 inches. 

Height of Wheels, ....... 30 

Height of Arms above Seat, 9^ 

Height of Seat from floor, 23 

Height of Seat from Foot-board, 17 

Width of Seat, 19 

Depth of Seat, 19 

Will pass through a doorway not less than 29 inches wide. 

Price, $3, in addition to prices quoted for No. 355. 






530 



A. A. MAKES, ARTIFICIAL LIMBS, NEW YORK CITY. 



No. 1358 is also the same as No. 1355 with divided extension 
foot-rest, which is peculiarly suitable for persons who desire to have 
the foot-rests adjustable and independent of each other. The occu- 





No. 1357. No. 1358. 

pant can control the operations of either rest. The foot-rests are 
not only capable of being placed at different angles, but can be ex- 
tended to accommodate a long leg. 

Price, $5, in addition to prices quoted for No. 1355. 

We have chairs of smaller dimensions than the preceding, suitable 
for children. 

Any of the above chairs are now made with ball bearings and 
pneumatic tires. These improvements will add to the cost of each 
chair, $25 for each pair of wheels and $12.50 for each single wheel. 

Chairs for children or for very heavy persons will be made to order, 
prices according to the conditions. 



Catalogues descriptive of Marks' artificial legs and arms with rubber feet 
and hands are printed in the following languages : Spanish, French, and 
German. They are not as comprehensive as the treatise which is printed 
exclusively in English. They contain, however, the main features of our 
inventions. A copy of either will be sent free of charge to anyone in any 
part of the world, upon request. 

Address, 

A. A. Marks, 

701 Broadway, New York, U. S. A. 



r c p 



LIBRARY OF CONGRESS 

021 062 786 8 



